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Wang S, Yin X, Jiang T, Xu J, Wang D. Impact of Cardiovascular and Cerebrovascular Diseases Mortality on Life Expectancy in Tianjin, 2004 and 2020. Asia Pac J Public Health 2024:10105395241251531. [PMID: 38736321 DOI: 10.1177/10105395241251531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
This study aims to analyze the impact of cardiovascular and cerebrovascular diseases (CCVDs) mortality on Tianjin's life expectancy (LE) in 2004 compared with 2020 using Arriaga's decomposition method. The LE increment for Tianjin residents due to the decrease in CCVDs mortality was 1.54 years (38.7%). Males, females, urban residents, and rural residents contributed 1.29 years (36.83%), 1.76 years (40.25%), 2.11 years (44.41%), and 0.71 years (25.06%), respectively. A total of 38.2% of the LE increment was attributed to deaths from CCVDs in people aged ≥65 years. Cerebral infarction, intracerebral hemorrhage, acute myocardial infarction, and other heart diseases contributed positively to the increase in LE (24.8%, 22.68%, 16.66%, and 11.3%). Sequelae of cerebrovascular disease and other coronary heart diseases contributed negatively to the increase in LE (-25.2% and -17.92%). Therefore, we need to control the risk factors of the elderly, males, rural residents, sequelae of cerebrovascular disease, and other coronary heart diseases.
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Affiliation(s)
- Shiyu Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Xiaolin Yin
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Tingting Jiang
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jiahui Xu
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Dezheng Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
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Leung WK. Oral health through primary healthcare in a developed economy dominated by private dental practitioners: A leap forward in Hong Kong? J Dent 2024; 144:104933. [PMID: 38461885 DOI: 10.1016/j.jdent.2024.104933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
After two and a half decades of preparation, and prompted by advocacy from the World Health Organization in 2014, the Health Bureau of Hong Kong recently implemented the city's primary healthcare blueprint. Integrated within it is an approach to primary oral healthcare. This review provides a brief background and discusses the development of primary oral healthcare in Hong Kong - a developed economy in Asia dominated by private dental services.
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Affiliation(s)
- Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China.
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Hu B, Wang Y, Chen D, Feng J, Fan Y, Hou L. Temporal trends in the prevalence and death of ischemic heart disease in women of childbearing age from 1990 to 2019: a multilevel analysis based on the Global Burden of Disease Study 2019. Front Cardiovasc Med 2024; 11:1366832. [PMID: 38711792 PMCID: PMC11070499 DOI: 10.3389/fcvm.2024.1366832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
Background Our objective is to describe the current prevalence and death of ischemic heart disease (IHD) in women of childbearing age (WCBA) at the global, regional, and national levels and to analyze its temporal trends from 1990 to 2019. Methods WCBA was defined as women aged 15-49 years. Estimates and 95% Uncertainty Intervals (UI) of IHD prevalence and death numbers for seven age groups were extracted from the 2019 Global Burden of Disease Study. The age-standardized prevalence and death rate (ASPR and ASDR) of IHD in WCBA was estimated using the direct age-standardization method. Joinpoint regression analysis was used to calculate average annual percent change (AAPC) to represent the temporal trends from 1990 to 2019. Results Between 1990 and 2019, the global ASPR of IHD experienced a 3.21% increase, culminating in 367.21 (95% UI, 295.74-430.16) cases per 100,000 individuals. Conversely, the ASDR decreased to 11.11 (95% UI, 10.10-12.30) per 100,000 individuals. In 2019, among the five sociodemographic index (SDI) regions, the highest ASPR was observed in the high-middle SDI region, whereas the highest ASDR was found in the low-middle SDI region. Regionally, the Caribbean reported the highest ASPR (563.11 per 100,000 individuals; 95% UI, 493.13-643.03), and Oceania reported the highest ASDR (20.20 per 100,000 individuals; 95% UI, 13.01-31.03). At the national level, Trinidad and Tobago exhibited the highest ASPR (730.15 per 100,000 individuals; 95% UI, 633.96-840.13), and the Solomon Islands had the highest ASDR (77.77 per 100,000 individuals; 95% UI, 47.80-121.19). Importantly, over the past three decades, the global ASPR has seen a significant increase [AAPC = 0.11%, 95% Confidence Interval (CI): 0.09-0.13; P < 0.001], while the ASDR has demonstrated a significant decreasing trend (AAPC = -0.86%, 95% CI: -1.11 to -0.61; P < 0.001). Air pollution, tobacco use, high systolic blood pressure, elevated body mass index, dietary risks, and high LDL cholesterol have been identified as the leading six risk factors for IHD-related deaths among WCBA in 2019. Conclusions Despite the significant decline in the global ASDR for IHD among WCBA over the last thirty years, the ASPR continues to escalate. We need to remain vigilant about the increased burden of IHD in WCBA. It calls for aggressive prevention strategies, rigorous control of risk factors, and the enhancement of healthcare coverage to mitigate the disease burden of IHD among WCBA in forthcoming years.
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Affiliation(s)
- Ben Hu
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China
| | - Yan Wang
- Academy of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dong Chen
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Jun Feng
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Linlin Hou
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China
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Yin J, Deng R, Meng Q, Feng Y, Zhang T. The future of universal health coverage: How can low- and middle-income countries 'break free from cocoons and transform'? J Glob Health 2024; 14:03021. [PMID: 38483437 PMCID: PMC10939111 DOI: 10.7189/jogh.14.03021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Jianzhong Yin
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
- Baoshan College of Traditional Chinese Medicine, Baoshan, China
- Healthy Yunnan Development Think Tank, Kunming, China
| | - Rui Deng
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
| | - Qiong Meng
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
| | - Yuemei Feng
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
| | - Teng Zhang
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
- Baoshan College of Traditional Chinese Medicine, Baoshan, China
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Huang Y, Zhou Y, Hong Y, Dai W, Lin K, Liu Y, Yan Y, Huang S, Li X, Yang Y, Jiang H. Development of a risk estimation model for condomless sex among college students in Zhuhai, China: a cross-sectional study. BMC Public Health 2024; 24:742. [PMID: 38459535 PMCID: PMC10921646 DOI: 10.1186/s12889-024-18183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/22/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Condom use at last intercourse is an effective indicator for human immunodeficiency virus (HIV) prevention. To identify at-risk individuals and improve prevention strategies, this study explored factors associated with condomless sex at last intercourse in the last year and developed a risk estimation model to calculate the individual possibility of condomless sex among college students in Zhuhai, China. METHODS A cross-sectional study was conducted among 1430 college students who had sex in the last year from six universities in Zhuhai. The least absolute shrinkage and selection operator (LASSO) and logistic regression were performed to explore the predictors of condomless sex. The nomogram was constructed to calculate the individual possibility of condomless sex. Discrimination and calibration of the nomogram were evaluated using the area under the receiver-operator characteristic curve (AUROC) and the calibration curve. RESULTS The proportion of students who had condomless sex at last intercourse was 18.2% (260/1430). Students who had experienced more types of intimate partner violence (aOR, 1.58; 95% CI, 1.31 ~ 1.92) and had anal sex (aOR, 1.75; 95% CI, 1.06 ~ 2.84) were more likely to have condomless sex. Students who had heterosexual intercourse (aOR, 0.37; 95% CI, 0.21 ~ 0.70), used condoms at first sex (aOR, 0.20; 95% CI, 0.14 ~ 0.27), had high attitudes towards condom use (aOR, 0.87; 95% CI, 0.80 ~ 0.95) and self-efficacy for condom use (aOR, 0.84; 95% CI, 0.78 ~ 0.90) were less likely to have condomless sex. The nomogram had high accuracy with an AUROC of 0.83 and good discrimination. CONCLUSIONS Intimate partner violence, anal sex, condom use at first sex, attitude towards condom use, and self-efficacy for condom use were associated with condomless sex among college students. The nomogram was an effective and convenient tool for calculating the individualized possibility of condomless sex among college students. It could help to identify individuals at risk and help universities and colleges to formulate appropriate individualized interventions and sexual health education programs.
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Affiliation(s)
- Ying Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yeting Hong
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wencan Dai
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Kaihao Lin
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yawei Liu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yao Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shanzi Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Xiaofeng Li
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
- Institute for Global Health, University College London, London, UK.
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Wang L, Chao J, Wu Y, Zhang N, Bao M. Social integration and utilization of national basic public health services among China's internal migrants with chronic diseases: A structural equation modelling approach. Heliyon 2024; 10:e25797. [PMID: 38352800 PMCID: PMC10862671 DOI: 10.1016/j.heliyon.2024.e25797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 01/28/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Internal migrants with chronic diseases (IMCDs) are a specific subgroup of the internal migrants, but few studies have focused on health service utilization among this group. Social integration is an essential element in the maintenance of health and well-being in migrants. However, the measurement of social integration remains inconsistent. This study aimed to measure social integration more comprehensively and evaluate the association between social integration and National Basic Public Health Services (NBPHS) utilization among IMCDs in China, thereby providing theoretical support for health promotion among IMCDs. The data of this study were obtained from the China Migrants Dynamic Survey (CMDS) in 2017. A total of 9272 internal migrants who self-reported hypertension and/or type 2 diabetes were included in the analysis. Four factors were extracted through exploratory factor analysis to measure the social integration of IMCDs: psychological identity, community involvement, social security, and sociocultural adaptation. The results show the IMCDs underutilized NBPHS, with 26.80 % stating that they have not used any of the services in the NBPHS. We confirmed the positive association between social integration and NBPHS use among IMCDs. The social integration of IMCDs in developed regions was relatively worse than in developing regions, further exacerbating the underutilization of NBPHS in developed regions. Therefore, targeted government measures and supportive policies are necessary, especially in developed regions, to encourage IMCDs to participate in social organizations and community activities and stimulate their active participation in the NBPHS.
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Affiliation(s)
- Leixia Wang
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Jianqian Chao
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Yanqian Wu
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Na Zhang
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Min Bao
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
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Beccia F, Di Marcantonio M, Causio FA, Schleicher L, Wang L, Cadeddu C, Ricciardi W, Boccia S. Integrating China in the International Consortium for Personalised Medicine: a position paper on innovation and digitalization in Personalized Medicine. BMC Public Health 2024; 24:464. [PMID: 38355452 PMCID: PMC10865700 DOI: 10.1186/s12889-024-18009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/06/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The advent of Personalized Medicine (PM) holds significant promise in revolutionizing healthcare by tailoring treatments to individual patients based on their data. However, its successful implementation requires the seamless integration of innovative technologies and presents formidable challenges in terms of sustainability. To tackle these challenges head-on, the International Consortium for Personalized Medicine (ICPerMed) was established, and the IC2PerMed project, as part of this consortium, seeks to foster collaboration between the European Union (EU) and China in the field of Personalized Medicine. Based on the results collected by the project, the objective of this study is to discern the key priorities for the implementation of Personalised Medicine concerning Information and Communication Technologies (ICT) and Big Data and digital solutions, with a particular emphasis on data management and protection. METHODS A Delphi survey was conducted to gather expert's consensus on the main priorities for actions on Information and Communication Technologies (ICT) and Big Data and digital solutions in the field of Personalized Medicine. RESULTS The survey identified seven priorities in the area of Big Data and digital solutions, including data interoperability, standards, security measures, and international partnerships. Additionally, twelve priorities were identified for the innovation-to-market process, emphasizing cost-effectiveness, need assessment, and value definition in resource allocation. CONCLUSIONS The effective implementation of new technologies in Personalized Medicine research and practice is essential for the advancement of healthcare systems in both the European and Chinese contexts. The identified priorities play a pivotal role in promoting the sustainability of health systems and driving innovation in the implementation of Personalized Medicine. Addressing challenges related to data interoperability, standards, security, international collaboration, cost-effectiveness, and value assessment is of utmost importance in order to propel the progress of Personalized Medicine in healthcare systems.
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Affiliation(s)
- Flavia Beccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | | | - Francesco Andrea Causio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | | | | | - Chiara Cadeddu
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Zhao D, Lu J, Zeng W, Zhang C, You Y. Changing trends in disease burden of lung cancer in China from 1990-2019 and following 15-year prediction. Curr Probl Cancer 2024; 48:101036. [PMID: 37926577 DOI: 10.1016/j.currproblcancer.2023.101036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/19/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND As lung cancer becomes a primary source of death in China, investigation on incidence rate, death rate, and disability-adjusted life years (DALYs) is of great significance to optimize prevention measures and allocation of healthcare resources. METHODS We utilized data from the Global Burden of Disease (GBD) database to evaluate the incidence rate, death rate, and DALYs of lung cancer in China from 1990 to 2019. Analysis of lung cancer risk factor-related death rate and DALYs was performed. Age-standardized rates (ASR) and estimated annual percentage change (EAPC) were calculated. The incidence trend of lung cancer from 2020 to 2034 was predicted by the Nordpred age-period-cohort (APC) model. RESULTS Age-standardized incidence rate (ASIR) increased from 30.2/100000 (95 % UI 26.2-34.3) in 1990 to 41.7/100000 (95 % UI 35.2-48.8) in 2019, and EAPC was 1.33 (95 % CI 1.16-1.49). From 1990 to 2019, men were noted for the highest incidence rate, death rate, and DALYs rate across three age groups (15-49 years, 50-69 years, and over 70). During this period, the ASIR of lung cancer in females was always lower than that in males. The predominant risk factors of lung cancer were smoking, air pollution, and diet, among which smoking was the most significant one. The analysis results showed that new cases and deaths may increase in the following 15 years since 2020 in the context of lung cancer. CONCLUSION Faced with the heavy burden of lung cancer, China must issue corresponding policies and roll out prevention avenues against smoking and air pollution.
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Affiliation(s)
- Di Zhao
- Department of Cardio-Thoracic Surgery, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, 434000, China; Hubei Clinical Medicine Research Center for individualized cancer diagnosis and therapy, Jingzhou, Hubei Province, 434000, China
| | - Jinzhi Lu
- Hubei Clinical Medicine Research Center for individualized cancer diagnosis and therapy, Jingzhou, Hubei Province, 434000, China
| | - Wen Zeng
- Laboratory Department of Hospital of Jingzhou Traditional Chinese Medicine Hospital, Jingzhou, Hubei Province, 434000, China
| | - Cong Zhang
- Department of Cardio-Thoracic Surgery, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, 434000, China
| | - Yonghao You
- Department of Cardio-Thoracic Surgery, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, 434000, China; Hubei Clinical Medicine Research Center for individualized cancer diagnosis and therapy, Jingzhou, Hubei Province, 434000, China.
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Qin S, Wang X, Li S, Wu M, Wan X. Personalizing age of gastric cancer screening based on comorbidity in China: Model estimates of benefits, affordability and cost-effectiveness optimization. Prev Med 2024; 179:107851. [PMID: 38191061 DOI: 10.1016/j.ypmed.2024.107851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/10/2024]
Abstract
The benefits of gastric cancer screening are related to age and comorbidity status, but reliable estimates are lacking in China. This study aimed to estimate the benefits and affordability of the gastric cancer screening strategy by level of comorbidity to inform decisions to screening age. We assessed six current gastric cancer screening strategies in China using a microsimulation model with different starting and stopping ages and comorbidity profiles, for a total of 378 strategies. 1,000,000 individuals were simulated in the model and followed the alternative strategies. Primary outcomes included gastric cancer incidence, the number of endoscopy and complications, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Future costs and QALYs are discounted by 5% per year. Sensitivity analyses were used to evaluate model uncertainty. Strategies with longer screening durations were associated with higher benefits of life-year gained and gastric cancer deaths averted, but were also accompanied by a large number of endoscopy screening, and complication events. Using the threshold of US$18,575 per QALY gained, at the no, moderate, and severe comorbidity level, the leading cost-effectiveness strategies were the new gastric cancer screening scoring system strategy (NGCS) screening from age 40 years to 60 years (40-60), 40-55-NGCS, and 40-55-NGCS strategy, respectively. The results are robust in sensitivity analyses. Our study illustrates the importance of considering comorbidity conditions and age when determining the starting and stopping screening age for gastric cancer and informs the discussion on personalizing decisions. The trade-off between benefits and harms can also be referenced when necessary.
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Affiliation(s)
- Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan, China; Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Sini Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan, China.
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Chen J, Wang S, Han Y, Zhang Y, Li Y, Zhang B, Li X, Zhang J. Geodetector analysis of individual and joint impacts of natural and human factors on maternal and child health at the provincial scale. Sci Rep 2024; 14:1643. [PMID: 38238587 PMCID: PMC10796915 DOI: 10.1038/s41598-024-52282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024] Open
Abstract
This ecological study examined the individual and joint impacts of natural-human factors on the spatial patterns of maternal and child health status in China at the provincial scale in 2020. We considered natural factors (forest coverage, average temperature, and total sulfur dioxide and particulate matter emissions) and human factors (economic development, urbanization, healthcare access, and education level). We combined maternal, infant, and under-five mortality rates into a composite maternal and child health index using the entropy method. The spatial autocorrelation analysis of this index highlighted distinct health patterns across provinces, whereas the geodetector method assessed the effects of natural-human factors on the patterns. A notable east-central-west stepwise decline in health status was observed. Global Moran's I showed positive spatial clustering, with high-high clustering areas in the Yangtze River Delta and low-low clustering areas in western regions. Factor detection identified eight significant natural-human factors impacting maternal and child health, with total sulfur dioxide emission density having the greatest impact. The interaction between average schooling years and total sulfur dioxide emission notably affected maternal and child health patterns. The study concludes that natural-human factors critically affect the spatial distribution of maternal and child health.
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Affiliation(s)
- Jialu Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Shuyuan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Ying Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yongjin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yuansheng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Beibei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Xiang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Junhui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China.
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Ning C, Pei H, Huang Y, Li S, Shao Y. Does the Healthy China 2030 Policy Improve People's Health? Empirical Evidence Based on the Difference-in-Differences Approach. Risk Manag Healthc Policy 2024; 17:65-77. [PMID: 38204928 PMCID: PMC10778192 DOI: 10.2147/rmhp.s439581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Background The Healthy China 2030 (HC2030) policy is currently recognized as China's most significant and influential national health policy. However, despite its implementation in 2016, the policy's impact has yet to be comprehensively evaluated, particularly in relation to its effectiveness in enhancing population health and promoting public health equity. Methods We utilized the Difference-in-Differences (DiD) method to evaluate the impact of the HC2030. Our analysis utilized a panel dataset derived from five longitudinal surveys conducted by the China Family Panel Studies (CFPS). Results The implementation of HC2030 has improved the overall health status of residents, particularly in urban areas and the western and eastern regions. Mechanistic analysis has further unveiled that the policy's beneficial impact on health outcomes is attributed to a rise in physical activity frequency and the betterment of mental health. Additionally, female, married, and medically insured individuals have demonstrated a significant positive impact of the policy on their health outcomes. Conclusion Although the HC2030 appears to have effectively improved overall population health, it needs to promote equity in public health adequately. The study suggests adjustments are needed to address the unequal distribution of health outcomes between urban and rural areas and among different regions.
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Affiliation(s)
- Chuanlin Ning
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Huacheng Pei
- School of Finance, Shanghai University of Finance and Economics, Shanghai, People’s Republic of China
| | - Youjia Huang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Sichen Li
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yiling Shao
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
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Zhu J, Wu Q, Zhang S, Song B, Wang W. Cracking the code of health security: unveiling the balanced indices through rank-ordered effect analysis. BMC Health Serv Res 2024; 24:27. [PMID: 38178218 PMCID: PMC10768473 DOI: 10.1186/s12913-023-10503-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Health security is a critical issue which involves multiple dimensions. It has received increasing attention in recent years, especially in China. In order to improve the national health level, China has made many efforts, such as the "Healthy China 2030" plan proposed several years ago. However, due to the complexity of its national conditions and the difficulty of index design, the results of these efforts are not significant. Therefore, it is necessary to construct a new measurement index system. METHODS Based on the questionnaire of "Health China 2030", we have collected a total of 3,000 participants from all 31 provinces, autonomous regions, and municipalities in China. We used statistical methods such as multiple correspondence analysis and rank-ordered effect analysis to process the data. The balance index is constructed by a series of actions such as weight division, order calculation and ranking. RESULTS Through multiple correspondence analysis, we can find that there was a close relation in the correspondence space between the satisfaction degrees 1, 2, and 3, while a far distance from satisfaction degrees 4 and 5. There were four positive and four negative indices separately based on the average expected level and four clusters after ordinal rank cluster analysis. Generally speaking, there are no prominent discrepancies across gender and residential areas. CONCLUSIONS We created and examined balanced indicators for health security in China based on the "Health China 2030" questionnaire. The findings of this study give insight into the overall situation of health security in China and indicate opportunities for improvement.
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Affiliation(s)
- Jianping Zhu
- School of Management, Xiamen University, Xiamen, China
- Data-Mining Research Center, Xiamen University, Xiamen, China
| | - Qi Wu
- School of Management, Xiamen University, Xiamen, China
- Data-Mining Research Center, Xiamen University, Xiamen, China
| | - Shiqi Zhang
- School of Management, Xiamen University, Xiamen, China
| | - Boliang Song
- School of Management, Xiamen University, Xiamen, China
| | - Weiwei Wang
- The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
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Mi Y, Huai L, Yin Y, Yuan J, Liu Y, Huang J, Li W. Burden of stroke in China and the different SDI regions over the world. J Glob Health 2023; 13:04169. [PMID: 38131457 PMCID: PMC10740341 DOI: 10.7189/jogh.13.04169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background Stroke is a significant global health issue, ranking as the second leading cause of death and the third leading cause of death and disability combined. This study aimed to examine the changes and differences in stroke burden from 1990 to 2019 in China and various global socio-demographic index (SDI) regions. Methods Data were obtained from the Global Burden of Diseases Study 2019, which included the incidence, prevalence, mortality, disability-adjusted life years (DALY), years of life with disability (YLD), and years of life lost (YLL) of stroke. The change trend of stroke burden was assessed based on age-standardised rates per 100 000 person-years and estimated annual percentage changes. The average annual rate of change in stroke burden was analysed using the average annual percentage change from 1990 to 2019. Pearson correlation analysis was used to explore the strength and direction of the correlation between stroke burden and SDI. Results Regions with high SDI showed the largest decline in age-standardised incidence, death, DALY, YLD, and YLL rates of stroke from 1990 to 2019. China experienced the largest increase in age-standardised prevalence and YLD rates of stroke from 1990 to 2019. There were significant differences in the average annual percent change in stroke burden among the majority of SDI regions. The burden for stroke at the national level was inversely correlated with SDI, despite some exceptions (Incidence: R = -0.417, P < 0.001; prevalence: R = -0.297, P < 0.001; mortality: R = -0.510, P < 0.001; DALY: R = -0.550, P < 0.001; YLD: R = -0.125, P = 0.075; YLL: R = -0.569, P < 0.001). Conclusions There were significant differences in the stroke burden across different regions with varying SDI levels from 1990 to 2019. The age-standardised prevalence rate and attributable disability burden of stroke remain substantial in different SDI regions, making it a major contributor to the overall disease burden. The severe burden of stroke highlights the importance of primary and secondary stroke-prevention strategies. Therefore, future strategies to prevent and reduce the burden of stroke should be formulated and implemented according to the SDI of each country.
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Affiliation(s)
- Yuqing Mi
- School of Public Health, Weifang Medical University, Weifang, China
| | - Lei Huai
- ZIBO TCM- INTEGRATED HOSPITAL, Zibo, China
| | - Yanling Yin
- Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
| | - Jinbao Yuan
- Finance Department, Weifang Medical University, Weifang, China
| | - Yuzhuo Liu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Jingwen Huang
- School of Public Health, Weifang Medical University, Weifang, China
| | - Wei Li
- School of Public Health, Weifang Medical University, Weifang, China
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Dong Y, Kuang X, Dong L, Chao G, Qi J, Zhang X, Yao J. Exploring the efficacy of traditional Chinese medicine exercise in alleviating anxiety and depression in older adults: a comprehensive study with randomized controlled trial and network meta-analysis. Front Psychol 2023; 14:1290471. [PMID: 38146395 PMCID: PMC10749367 DOI: 10.3389/fpsyg.2023.1290471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023] Open
Abstract
Background Anxiety and depression pose a significant global health challenge for elderly individuals. Research has demonstrated the potential of traditional Chinese medicine (TCM) exercise therapies in alleviating these conditions. However, ongoing debate and uncertainty persist regarding the optimal therapy and its impact on anxiety and depression. This study aims to evaluate and prioritize TCM exercise therapies for anxiety and depression in older adults, to identify the most effective intervention, and to provide a basis for informed decision-making in clinical practice. Methods We conducted a comprehensive search of electronic databases including The Web of Science, PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wang Fang, and Wei Pu database up to July 2022. Two researchers independently reviewed all included studies and extracted relevant data. Traditional meta-analysis was performed using Review Manager version 5.4, while network meta-analysis was conducted using STATA software version 15.1 to generate network evidence plots and funnel plots. Result A total of 30 trials, involving 2,806 participants, met the eligibility criteria. The traditional meta-analysis revealed that TCM exercise significantly improved anxiety (SMD = -0.82, 95% CI = -1.39, -0.26, p = 0.004) and depression (SMD = -0.63, 95% CI = -0.85, -0.41, p < 0.01) compared to the control group. In the network meta-analysis, Tai Chi exercise was ranked as the most effective intervention for anxiety (68.3%), followed by Yi Jin Jing (63.6%). For depression, the Tai Chi exercise was ranked as the most effective (87.8%), followed by the Ba Duan Jin exercise (74.1%). Conclusion TCE exercise can improve anxiety and depression in older adults, Among the four TCE exercise therapies included, Tai Chi exercise showed better efficacy than other types of treatment. Nevertheless, further research is required to validate the effectiveness of this exercise therapy through larger and more rigorous clinical trials. Systematic review registration http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023438697.
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Affiliation(s)
- Yangjian Dong
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
- College of Physical Education, China Three Gorges University, Yichang, China
| | - Xiaoqin Kuang
- College of Physical Education and Health, Guangxi University, Guilin, China
| | - Lili Dong
- College of Physical Education, China Three Gorges University, Yichang, China
| | - Guodong Chao
- College of Physical Education, China Three Gorges University, Yichang, China
| | - Juancai Qi
- School of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Xinxin Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Jiwei Yao
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
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Miao Y, Zhao S, Liu W, Jiang H, Li Y, Wang A, Zhang Y. Prevalence and risk factors of delayed onset lactogenesis II in China: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2023; 36:2214833. [PMID: 37258287 DOI: 10.1080/14767058.2023.2214833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND In 2017, China proposed to achieve the goal that 50% of infants aged 0-6 months should be exclusively breastfed by 2025 proposed by the World Health Assembly in 2012. However, delayed onset lactogenesis II has adverse effects on breastfeeding and thus on neonatal health. There has been no meta-analysis of the prevalence and risk factors of delayed onset lactogenesis II among parturient women in China. To provide best practices, updated evidence-based evidence is needed to supplement reviews on this topic. OBJECTIVE The purpose of this systematic review and meta-analysis was to quantitatively analyze the prevalence and risk factors of delayed onset lactogenesis II in China. METHODS We identified relevant studies by searching literature published prior to October 2022 in PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases for all available observational studies. Stata 16.0 were used for performing the systematic review and meta-analysis. RESULTS The researchers examined data from 14 observational studies involving 17610 females. The prevalence of delayed onset lactogenesis II from these studies was 31% (95% CI = 25.0%-38.0%, p < .001), and the prevalence showed a significant increasing trend in China over the past decade. The frequency of breastfeeding was >2 times per day at 24-48 h after delivery was one protective factor against delayed onset lactogenesis II (OR = 0.41). The significant risk factors for delayed onset lactogenesis II were breastfeeding initiation > 30min after birth (OR = 1.31), maternal age > 35 years (OR = 2.19), primiparous women (OR = 2.38), maternal overweight/obesity (OR = 2.22), cesarean section (OR = 1.33), anxiety (OR = 3.23), depression (OR = 3.21) and gestational hypertension (OR = 3.43). CONCLUSIONS There is a high incidence of delayed onset lactogenesis II in Chinese parturient women. We identified eight risk factors and one protective factor for DOL II. These findings suggest health care professionals should pay attention to these risk parturients so as to better provide early preventive interventions to increase the breastfeeding rate.
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Affiliation(s)
- Yiqun Miao
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
| | - Shuliang Zhao
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
| | - Wenwen Liu
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
| | - Huimin Jiang
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
| | - Yanan Li
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
| | - Aihua Wang
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
| | - Yuanyuan Zhang
- School of Nursing, Weifang Medical University, Weifang, Shandong province, China
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Liu B, Wang L, Zhang L, Liao Z, Wang Y, Sun Y, Xin J, Hu B. Analysis of severe ozone-related human health and weather influence over China in 2019 based on a high-resolution dataset. Environ Sci Pollut Res Int 2023; 30:111536-111551. [PMID: 37819470 DOI: 10.1007/s11356-023-30178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
Ozone pollution in 2019 in China is particularly severe posing a tremendous threat to the health of Chinese inhabitants. In this study, we constructed a more reliable and accurate 1-km gridded dataset for 2019 with as many sites as possible using the inverse distance weight interpolation method to analyze spatiotemporal ozone pollution characteristics and health burden attributed to ozone exposure from the perspective of different diseases and weather influence. The accuracy of this new dataset is higher than other public datasets, with the coefficient of determination of 0.84 and root-mean-square error of 8.77 ppb through the validation of 300 external sites which were never used for establishing retrieval methods by the datasets mentioned-above. The averaged MDA8 (the daily maximum 8 h average) ozone concentrations over China was 43.5 ppb, and during April-July, 83.9% of total grids occurred peak-month ozone concentrations. Overall, the highest averaged exceedance days (60 days) and population-weighted ozone concentrations (55.0 ppb) both concentrated in central-eastern China including 9 provinces (only 11.4% of the national territory); meanwhile, all-cause premature deaths attributable to ozone exposure reached up to 142,000 (54.9% of national total deaths) with higher deaths for cardiovascular and respiratory, and the provincial per capita premature mortality was 0.27~0.44‰. The six most polluted weather types in the central-eastern China are in order as follows: westerly (SW and W), cyclonic, northerly, and southerly (NW, N, and S) types, which accounts for approximately 73.2% of health burden attributed to daily ozone exposure and poses the greatest public health risk with mean daily premature deaths ranging from 466 to 610. Our findings could provide an effective support for regional ozone pollution control and public health management in China.
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Affiliation(s)
- Boya Liu
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Lili Wang
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China.
| | - Lei Zhang
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhiheng Liao
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, 100089, China
| | - Yuesi Wang
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yang Sun
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
| | - Jinyuan Xin
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
| | - Bo Hu
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
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Gao L, Moodie M, Watts JJ, Wang L. Cost-Effectiveness of Osteoporosis Opportunistic Screening Using Computed Tomography in China. Value Health Reg Issues 2023; 38:38-44. [PMID: 37454646 DOI: 10.1016/j.vhri.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Underutilization and insufficient availability of dual-energy X-ray absorptiometry (DXA) in diagnosing osteoporosis in China could be changed by adopting unindicated quantitative computed tomography. We aimed to assess the cost-effectiveness of quantitative computed tomography (QCT) as a screening tool for osteoporosis in China. METHODS A Markov microsimulation model was developed to assess the long-term costs and quality-adjusted life-years (QALYs) saved associated with 2 examinations as opportunistic screening for osteoporosis in a general population without prior histories of fracture. The diagnostic performance of both examinations was incorporated into the model. In lifetime modeling, opportunistically screened people may face the risk of experiencing hip, vertebral, and wrist fractures depending on their osteoporosis, age, and sex. Model parameters were informed by published literature. RESULTS The base-case result showed that QCT was associated with higher costs ($6054 vs $5883) and higher benefits (10.081 vs 10.071 QALYs) in comparison with DXA, making QCT a cost-effective option for opportunistic screening (incremental cost-effectiveness ratio of US $16 430/QALY). Screening with QCT led to fewer fractures over the lifetime simulation: for every 10 000 people screened, 129 fractures (32 hip, 78 vertebral, and 19 wrist fractures) could be avoided because of the early initiation of antiosteoporotic treatment. CONCLUSIONS Using QCT to screen people for osteoporosis is more cost-effective than standard practice in China, where access to DXA is minimal. This finding could support opportunistic osteoporosis screening using QCT in other countries with similar status.
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Affiliation(s)
- Lan Gao
- Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Marj Moodie
- Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Jennifer J Watts
- Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
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Zhang M, Qu H, Xia J, Hui X, Shi C, Xu F, He J, Cao Y, Hu M. Trends, influencing factors and prediction analysis of under-five and maternal mortality rates in China from 1991 to 2020. Front Public Health 2023; 11:1198356. [PMID: 37927855 PMCID: PMC10620530 DOI: 10.3389/fpubh.2023.1198356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Under-five mortality rate (U5MR) and maternal mortality rate (MMR) are important indicators for evaluating the quality of perinatal health and child health services in a country or region, and are research priorities for promoting maternal and infant safety and maternal and child health. This paper aimed to analysis and predict the trends of U5MR and MMR in China, to explore the impact of social health services and economic factors on U5MR and MMR, and to provide a basis for relevant departments to formulate relevant policies and measures. Methods The JoinPoint regression model was established to conduct time trend analysis and describe the trend of neonatal mortality rate (NMR), infant mortality rate (IMR), U5MR and MMR in China from 1991 to 2020. The linear mixed effect model was used to assess the fixed effects of maternal health care services and socioeconomic factors on U5MR and MMR were explored, with year as a random effect to minimize the effect of collinearity. Auto regressive integrated moving average models (ARIMA) were built to predict U5MR and MMR from 2021 to 2025. Results The NMR, IMR, U5MR and MMR from 1991 to 2020 in China among national, urban and rural areas showed continuous downward trends. The NMR, IMR, U5MR and MMR were significantly negatively correlated with gross domestic product (GDP), the proportion of the total health expenditure (THE) to GDP, system management rate, prenatal care rate, post-natal visit rate and hospital delivery rate. The predicted values of national U5MR from 2021 to 2025 were 7.3 ‰, 7.2 ‰, 7.1 ‰, 7.1 ‰ and 7.2 ‰ and the predicted values of national MMR were 13.8/100000, 12.1/100000, 10.6/100000, 9.6/100000 and 8.3/100000. Conclusion China has made great achievements in reducing the U5MR and MMR. It is necessary for achieving the goals of Healthy China 2030 by promoting the equalization of basic public health services and further optimizing the allocation of government health resources. China's experience in reducing U5MR and MMR can be used as a reference for developing countries to realize the SDGs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mengcai Hu
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Yang L, Zhou Q, Wang C, Zhang D, Yuan T, Li X, Lei Y, Zhang L. Classification of health needs: a cluster analysis of older adults in urban areas. BMC Geriatr 2023; 23:638. [PMID: 37814238 PMCID: PMC10563358 DOI: 10.1186/s12877-023-04333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 09/20/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND In this study, a cross-sectional survey was used to understand and analyze the health status and health needs of the elderly in the community. The cluster analysis method was used to explore the relationship between health needs items and investigate the commonness among health demand items, to provide a reference for the development of health management of the elderly with chronic diseases. METHODS We used convenience sampling to recruit the participants (aged 60 and above) from four urban community centers in Jinzhou City, Liaoning Province, China, in this study. This study uses the Medical Outcomes Study(MOS)36-Item Short-Form Health Survey. The self-designed questionnaire includes sociodemographic characteristics, chronic diseases, physical examination conditions, illness in the past two weeks, and a health needs questionnaire. SPSS 18.0 was used for data entry and analysis. Data analysis methods included descriptive statistical analysis, t-test, one-way analysis, cluster analysis, and linear multiple regression analysis. RESULTS The rate of health needs among the elderly in the community for various health services is 1.3-69.7%, of which the top three are: regular physical examination (69.7%), day Care Center (67.7%), the establishment of a Medical Alert Systems (66.1%). The health needs of the elderly in the community are divided into three categories: basic needs (24 items), health education (13 items), and first aid (2 items). The regression analysis found that the influencing factors of health status were age, revenue and expenditure, medical expenses, health education, basic needs, and first aid. CONCLUSIONS The community should strengthen the management of chronic diseases of the elderly and the publicity and education of related knowledge, and provide complementary health care services according to the health needs of the elderly, improve the health of the elderly, and improve the quality of life of the elderly.
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Affiliation(s)
- Liu Yang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China
| | - Quan Zhou
- Department of nursing, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, 241004, Wuhu City, Anhui Province, P.R. China
| | - Congzhi Wang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China
| | - Dongmei Zhang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China
| | - Ting Yuan
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China
| | - Xiaoping Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China
| | - Yunxiao Lei
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China
| | - Lin Zhang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, 241002, Wuhu City, An Hui Province, P.R. China.
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Chu ECP, Lin AFC, Chu V. The Inclusion of Chiropractic Care in the Healthy China Initiative 2030. Cureus 2023; 15:e43068. [PMID: 37680438 PMCID: PMC10481885 DOI: 10.7759/cureus.43068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
The Healthy China Initiative 2030 represents a major shift in China's healthcare policies for health promotion and disease prevention. Chiropractic care, with its focus on musculoskeletal health and nonpharmacological treatment, can contribute to the goals of this initiative. However, its potential contribution is hampered by the lack of official recognition and regulation in mainland China, which restricts its general awareness and integration into healthcare systems, and potentially leads to untreated musculoskeletal disorders. This research proposes the inclusion of chiropractic care in the Healthy China Initiative 2030 framework. It provides an overview of the goals of this initiative and the current state of chiropractic care in China. The alignment of chiropractic principles and practices with the aims of the Healthy China Initiative 2030 is also discussed. Policy recommendations for integrating chiropractic care into the healthcare system are proposed, which include the establishment of education standards, licensing protocols, and collaborative research initiatives. Potential challenges, including regulatory barriers, a lack of awareness, and research limitations are highlighted. We also present potential strategies to leverage opportunities for promoting chiropractic care, such as the rising demand for musculoskeletal care. This research provides the first focused discussion on the integration of chiropractic care into China's evolving preventive healthcare landscape under the Healthy China Initiative 2030.
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Affiliation(s)
- Eric Chun-Pu Chu
- Research, Chiropractic Doctors' Association of Hong Kong, Hong Kong, CHN
| | - Andy Fu Chieh Lin
- Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
| | - Valerie Chu
- Research, Chiropractic Doctors' Association of Hong Kong, Hong Kong, CHN
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Wang J, Mo C, Sheng Q, Huang Y, Lin D, Liang Y, Zhang N. Association of length of service and job category with occupational health literacy of port employees in Shenzhen, China. BMC Public Health 2023; 23:1223. [PMID: 37353781 PMCID: PMC10288714 DOI: 10.1186/s12889-023-15769-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 04/26/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Health literacy (HL) is associated with health outcomes, but little is known about the occupational HL (OHL) for port employees and its link to the length of service and job category. METHOD A cross-sectional survey was conducted on 3492 port employees from the Occupational Health Survey for Port Employees project, and a special questionnaire was utilized to measure the OHL status. Binary and ordinal logistic regressions were used to estimate the association. RESULT Among the participants, 72.90% had sufficient OHL with a mean score (standard deviation) of 53.10 (7.26). Binary logistic regression results indicated that the association between length of service (33-40 years group Adjusted OR = 1.11; 41-49 years group Adjusted OR = 1.14; ≥50 years group Adjusted OR = 1.19) and job category (longshoremen Adjusted OR = 0.90; driver Adjusted OR = 0.91) with OHL were statistically significant. Ordinal logistic regression results indicated that, for OHL, Adjusted OR was increased in different lengths of service level (33-40 years group, Adjusted OR = 1.50; 41-49 years group, Adjusted OR = 1.75; ≥50 years group, Adjusted OR = 2.19), and the Adjusted OR of skilled workers was 1.60. CONCLUSION Most port participants had sufficient OHL, and the length of service and job category could affect OHL. The effect of the length of service may be more obvious; the length of service can promote the improvement of OHL continuously.
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Affiliation(s)
- Jinlin Wang
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, Guangdong, China
| | - Chunbao Mo
- School of medicine, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China
| | - Qiujie Sheng
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, Guangdong, China
| | - Yuehong Huang
- Shenzhen Chiwan Port Development Co., Ltd, Shenzhen, 518000, Guangdong, China
| | - Dafeng Lin
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, Guangdong, China
| | - Yuan Liang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Naixing Zhang
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, Guangdong, China.
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22
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Wei T, Li X, Qiang W, Zhang Y, Ren H, Zhang Q, Jin X. Menopausal symptoms in breast cancer patients receiving adjuvant endocrine therapy and their relationships with health-promoting behaviors and social support. Menopause 2023; 30:289-295. [PMID: 36728825 DOI: 10.1097/gme.0000000000002130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the prevalence and severity of menopausal symptoms in patients with breast cancer undergoing adjuvant endocrine therapy and explore the relationships of these symptoms with health-promoting behaviors and social support. METHODS This cross-sectional study investigated 226 participants from December 2020 to December 2021 in China. Data were collected using the sociodemographic information questionnaire, Menopause Rating Scale, the Health-Promoting Lifestyle Profile II, and Perceived Social Support Survey. Multivariate step regression was used to analyze the potential factors of menopausal symptoms. RESULTS In our sample of 226 patients, 92.9% reported at least one menopausal symptom with a mean score of 13 points (interquartile range, 9-18 points). The highest prevalence of most symptoms included hot flashes/night sweats, fatigue, joint and muscular discomfort, irritability, and sleep problems. In the regression models, health responsibility ( β = -0.15, P = 0.03), spiritual growth ( β = -0.28, P < 0.01), friend support ( β = -0.43, P < 0.01), and other support ( β = -0.31, P = 0.01) were negatively associated with menopausal symptoms. CONCLUSIONS The prevalence and severity of menopausal symptoms are high in breast cancer patients undergoing adjuvant endocrine therapy. Higher health-promoting behaviors and social support are associated with fewer menopausal symptoms. The findings highlight the clinical implications in terms of developing appropriate strategies for managing menopausal symptoms.
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Affiliation(s)
- Tingting Wei
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xia Li
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wanmin Qiang
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Nursing Department, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yan Zhang
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hailing Ren
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Department of Breast Oncology, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Qiupeng Zhang
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xue Jin
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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23
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Du Y, Hu N, Yu Z, Liu X, Ma Y, Li J. Characteristics of the cognitive function transition and influencing factors among Chinese older people: An 8-year longitudinal study. J Affect Disord 2023; 324:433-439. [PMID: 36586609 DOI: 10.1016/j.jad.2022.12.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/10/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cognitive impairment among older people is an important public health problem in developing countries. Therefore, it is necessary to identify the subtypes of cognitive function among older people in China, and explore the transformation patterns and influencing factors. METHODS Longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) were used, and included 2140 women and 2049 men aged over 60 years. Latent profile and latent transition analysis (LPA<A) were used to identify subgroups and transitions between the profiles over time. Influencing factors were identified by multinomial logistic regression analysis. RESULTS According to the LPA model, three subgroups of cognitive function were identified: Cognitive Impairment, Mild Cognitive Impairment (MCI) and Normal Cognitive Function. Concurrently, >50 % of participants were likely to progress to MCI after seven years, whereas participants with cognitive impairment had a probability of 54.2 % of transitioning to a better cognitive profile. Older adults are less likely to experience cognitive improvement, higher levels of education affect changes in cognition, and having depression are at a lower risk of cognitive decline. LIMITATIONS Due to the incompleteness of the cognitive assessment and the large time span, there was a certain bias in the classification and analysis of latent cognitive profiles. CONCLUSION This study identified three latent profiles among Chinese older people and showed the stability and heterogeneity. It demonstrated the effects of higher age or levels of education, and depression on changes in cognitive function in older people.
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Affiliation(s)
- Yurun Du
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Naifan Hu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Zhenfan Yu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xiaojuan Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yuzhuo Ma
- Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
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24
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Ma Y, Xiao P, Yu L, Ni H, Huang S, Wang M, Huang Y, Li L, Yang L, Tan C, Zhong Z. The allocation and fairness of health human resources in Chinese maternal and child health care institutions: a nationwide longitudinal study. BMC Health Serv Res 2023; 23:151. [PMID: 36782193 PMCID: PMC9926631 DOI: 10.1186/s12913-023-09076-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/17/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND In response to an aging population, the Chinese government implemented the three-child policy in 2021 based on the comprehensive two-child policy. With the implementation of the new birth policy, people's maternal and child health (MCH) needs will also increase. The allocation and fairness of MCH human resources directly affect people's access to MCH services. The purpose of this study is to analyze the allocation of health human resources in Chinese maternal and child health care institutions, evaluate the fairness of the allocation, to provide a reference for the rational allocation of MCH human resources. METHODS The data of health technicians, licensed (assistant) physicians, and registered nurses in maternal and child health care institutions nationwide from 2016 to 2020 were included. The health resource density index (HRDI) is used to evaluate the allocation level of MCH human resources. The Gini coefficient (G) and Theil index (T) are used to evaluate the fairness of the allocation of MCH human resources from the perspectives of population and geographic area. RESULTS From 2016 to 2020, the average annual growth rate of the number of health technicians, licensed (assistant) physicians, and registered nurses in Chinese maternal and child health care institutions was 7.53, 6.88, and 9.12%, respectively. The Gini coefficient (G) of the three types of MCH human resources allocated by population were all below 0.23, and the Gini coefficient (G) allocated by geographical area were all above 0.65. The Theil index (T) of the three types of MCH human resources allocated by population was all lower than 0.06, and the Theil index (T) allocated by geographical area was all higher than 0.53. In addition, the three types of MCH human resources allocated by population and geographic area contributed more than 84% of the Theil index within the group (Tintra) to the Theil index (T). CONCLUSIONS China's MCH human resources were fair in terms of population allocation, but unfair in terms of geographical area allocation. In the future, more attention should be paid to the geographical accessibility of MCH human resources, and the allocation of resources should comprehensively consider the two factors of serving the population and geographical area.
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Affiliation(s)
- Yuan Ma
- grid.461863.e0000 0004 1757 9397Department of Medical Record Management, West China Second University Hospital, Chengdu, Sichuan, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Pei Xiao
- grid.13291.380000 0001 0807 1581Medical Insurance Office, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan China
| | - Li Yu
- grid.461863.e0000 0004 1757 9397Department of Medical Record Management, West China Second University Hospital, Chengdu, Sichuan, China
| | - Henfan Ni
- grid.412901.f0000 0004 1770 1022Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Shiyao Huang
- grid.412901.f0000 0004 1770 1022Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan China ,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, Sichuan China
| | - Meixian Wang
- grid.461863.e0000 0004 1757 9397National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan China
| | - Yuxiang Huang
- grid.461863.e0000 0004 1757 9397Department of Medical Record Management, West China Second University Hospital, Chengdu, Sichuan, China
| | - Li Li
- grid.461863.e0000 0004 1757 9397Department of Medical Record Management, West China Second University Hospital, Chengdu, Sichuan, China
| | - Lian Yang
- grid.411304.30000 0001 0376 205XSchool of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan China
| | - Chunjian Tan
- grid.460068.c0000 0004 1757 9645Department of Quality Control and Evaluation, Chengdu Third People’s Hospital, Chengdu, Sichuan China
| | - Zhigang Zhong
- Department of Prevention, Office of Cancer Prevention and Treatment, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to University of Electronic Science and Technology of China, 610041, Chengdu, Sichuan, China.
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25
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Li H, Chen J, Su D, Xu X, He R. Is Co-Occurrence of Frailty and Multimorbidity Associated with Increased Risk of Catastrophic Health Expenditure? A Prospective Cohort Analysis in China. Risk Manag Healthc Policy 2023; 16:357-368. [PMID: 36919147 PMCID: PMC10008315 DOI: 10.2147/rmhp.s402025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/11/2023] [Indexed: 03/16/2023] Open
Abstract
Purpose The coexistence of multimorbidity and frailty is more likely to increase the risk of physical limitations, mortality and other adverse health outcomes in older adults than their individual occurrence. However, whether and how this coexistence is associated with catastrophic health expenditure (CHE) has not been well assessed. This study aimed to evaluate the independent and coexisting effects of frailty and multimorbidity on CHE. Participants and Methods A total of 4838 participants obtained from the China Health and Retirement Longitudinal Study (CHARLS) without CHE at baseline (2011) were included in the analytical sample. Marginal structural model (MSM) and time-varying Cox regression model were used to assess the independent and co-occurring impact of frailty and multimorbidity on CHE, respectively. Results Suffering from single chronic disease (HR, 1.26; 95% CI, 1.13-1.40; P < 0.001), multimorbidity (HR, 1.80; 95% CI, 1.63-1.99; P < 0.001) and frailty (HR, 1.32; 95% CI, 1.21-1.45; P < 0.001) were associated with a higher risk of CHE. Frailty co-occurring with a single chronic disease (HR, 1.28; 95% CI, 1.03-1.60; P = 0.027) or multimorbidity (HR, 1.91; 95% CI, 1.56-2.32; P < 0.001), and multimorbidity co-occurring with frailty also increased CHE risk (HR, 1.32; 95% CI, 1.17-1.48; P < 0.001) compared with single frailty or multimorbidity status. Conclusion Preventing, postponing, or reducing frailty, and enhancing standard management of chronic diseases are essential in reducing healthcare costs and preventing families from poverty. More efficient interventions for frailty and multimorbidity are urgently required.
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Affiliation(s)
- Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Jiangyun Chen
- Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Dai Su
- Department of Health Management and Policy, School of Public Health, Capital Medical University, Beijing, People's Republic of China
| | - Xiwu Xu
- School of Economics and Management, Beijing Jiaotong University, Beijing, People's Republic of China
| | - Ruibo He
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, People's Republic of China.,College of Finance and Public Administration, Hubei University of Economics, Wuhan, Hubei, People's Republic of China
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26
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Zhang J, Eggink E, Zhang X, Li X, Jiang B, Liu H, Ge S, Zhang W, Lyu J, Niu Y, Yu Y, Hou H, Xu X, Ye X, Wang W, Terlou R, Richard E, Wang W, Wang Y, Moll van Charante EP, Song M. Needs and views on healthy lifestyles for the prevention of dementia and the potential role for mobile health (mHealth) interventions in China: a qualitative study. BMJ Open 2022; 12:e061111. [PMID: 36414280 PMCID: PMC9684993 DOI: 10.1136/bmjopen-2022-061111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Over the coming decades, China is expected to face the largest worldwide increase in dementia incidence. Mobile health (mHealth) may improve the accessibility of dementia prevention strategies, targeting lifestyle-related risk factors. Our aim is to explore the needs and views of Chinese older adults regarding healthy lifestyles to prevent cardiovascular disease (CVD) and dementia through mHealth, supporting the Prevention of Dementia using Mobile Phone Applications (PRODEMOS) study. DESIGN Qualitative semi-structured interview study, using thematic analysis. SETTING Primary and secondary care in Beijing and Tai'an, China. PARTICIPANTS Older adults aged 55 and over without dementia with an increased dementia risk, possessing a smartphone. Participants were recruited through seven hospitals participating in the PRODEMOS study, purposively sampled on age, sex, living area and history of CVD and diabetes. RESULTS We performed 26 interviews with participants aged 55-86 years. Three main themes were identified: valuing a healthy lifestyle, sociocultural expectations and need for guidance. First, following a healthy lifestyle was generally deemed important. In addition to generic healthy behaviours, participants regarded certain specific Chinese lifestyle practices as important to prevent disease. Second, the sociocultural context played a crucial role, as an important motive to avoid disease was to limit the care burden put on family members. However, time-consuming family obligations and other social values could also impede healthy behaviours such as regular physical activity. Finally, there seemed to be a need for reliable and personalised lifestyle advice and for guidance from a health professional. CONCLUSIONS The Chinese older adults included in this study highly value a healthy lifestyle. They express a need for personalised lifestyle support in order to adopt healthy behaviours. Potentially, the PRODEMOS mHealth intervention can meet these needs through blended lifestyle support to improve risk factors for dementia and CVD. TRIAL REGISTRATION NUMBER ISRCTN15986016; Pre-results.
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Affiliation(s)
- Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Esmé Eggink
- Department of General Practice, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xingming Li
- Department of Health Administration and Policy, School of Public Health, Capital Medical University, Beijing, China
| | - Bin Jiang
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | - Hongmei Liu
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | - Siqi Ge
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | - Wei Zhang
- Centre for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital,Capital Medical University, Beijing, China
| | - Jihui Lyu
- Centre for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Yixuan Niu
- Department of Geriatrics, The Second Medical Centre & National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yueyi Yu
- Innovation Centre for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Haifeng Hou
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Science, Tai'an, Shandong, China
| | - Xizhu Xu
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Science, Tai'an, Shandong, China
| | - Xiaoyan Ye
- Comvee Research Institute, Fuzhou Comvee Network & Technology Co., Ltd, Fuzhou, China
| | - Wenzhi Wang
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | | | - Edo Richard
- Department of Public and Occupational Health, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Neurology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Science, Tai'an, Shandong, China
- Centre for Precision Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- Centre for Precision Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Eric P Moll van Charante
- Department of General Practice, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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27
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Wang J, Jin W, Shi L, Geng Y, Zhu X, Hu W. Health-Related Quality of Life in Children: The Roles of Age, Gender and Interpersonal Trust. Int J Environ Res Public Health 2022; 19:15408. [PMID: 36430127 PMCID: PMC9690605 DOI: 10.3390/ijerph192215408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Health-related quality of life (HRQoL) is an interesting topic in health care sciences and psychology. Deeper insight into the internal mechanism of this effect through large samples is crucial to further understanding HRQoL and making targeted suggestions to improve HRQoL. The present study aims to investigate the mediating role of interpersonal trust between age and HRQoL from a developmental lens. The purpose of this study was to profile the Pediatric Quality of Life Inventory 4.0 generic scale in China and test the relationship between age and health-related quality of life, as well as the mediating role of interpersonal trust and the moderating role of gender. A sample of 6248 children completed measures of demography, health-related quality of life, and interpersonal trust. Regression analyses were performed to test the mediating role of interpersonal trust and the moderating role of gender. Age was associated with lower health-related quality of life and lower interpersonal trust. Similarly, gender differences were also noted, with boys reporting higher health-related quality of life and lower interpersonal trust than girls. Additionally, the health-related quality of life of girls declined more than that of boys with increasing age. Regression analyses revealed that age could predict decreased health-related quality of life via lower levels of interpersonal trust. What is more, the mediation effect was moderated by gender, with the observed mediation effect being stronger among boys than girls. The current study replicates age and gender differences in health-related quality of life and interpersonal trust. Moreover, this study explained how and when age affected the health-related quality of life of children, and provided a deeper understanding of the relation between age and health-related quality of life.
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Affiliation(s)
- Jing Wang
- School of Politics and Public Administration, Zhengzhou University, Zhengzhou 450001, China
| | - Wenjing Jin
- School of Marxism, Zhengzhou University, Zhengzhou 450001, China
| | - Liping Shi
- Department of Psychology, School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
| | - Yaoguo Geng
- School of Marxism, Zhengzhou University, Zhengzhou 450001, China
- School of Education, Zhengzhou University, Zhengzhou 450001, China
| | - Xueli Zhu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Wanying Hu
- School of Education, Zhengzhou University, Zhengzhou 450001, China
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28
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Wang Z, Xie L, Liang Z, Fan J, Fan L, Deng J, Xu X. Perceived stress and humanistic care ability among Chinese healthcare workers: The chain mediating role of social support and life satisfaction. Front Psychol 2022; 13:1029265. [PMID: 36438328 PMCID: PMC9683107 DOI: 10.3389/fpsyg.2022.1029265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Previous studies have indicated high perceived stress and its relationship with life satisfaction among healthcare workers. However, most of the existing studies have focused on the investigation and evaluation of the humanistic care abilities among nurses, but few studies revealed the levels of humanistic care ability among other healthcare workers including doctors and technicians. The study aimed to investigate the perceived stress and humanistic care abilities among Chinese healthcare workers. In addition, we further examined the mediating and moderating effects of social support and life satisfaction. A convenience sample of 955 health professionals from 29 hospitals in China was recruited to fill out the questionnaires about perceived stress, humanistic care ability, social support, and life satisfaction. The correlation and multivariate logistic regression analysis were carried out by SPSS 24.0. The Hayes SPSS macro program process (version 2.16.3) was used to analyze the significance of mediating and moderating model. The findings indicated that humanistic care ability was negatively associated with perceived stress and positively correlated with social support and life satisfaction. The effect of the path “perceived stress → social support → humanistic care ability” was −0.017, and the path “perceived stress → life satisfaction → social support → humanistic care ability” was −0.129. The current study contributed to a better understanding of humanistic care abilities and influential factors in Chinese healthcare workers. Thus, it may suggest studies on interventions to interventions to alleviate or eliminate the negative impact of perceived stress and improve humanistic care abilities.
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Affiliation(s)
- Zonghua Wang
- Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China
| | - Langlang Xie
- Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China
- Department of Health Management and Geriatric Nursing, Daping Hospital, Chongqing, China
| | - Zeping Liang
- Department of Nursing, Daping Hospital, Chongqing, China
| | - Jiangshan Fan
- Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China
| | - Liqi Fan
- Department of Health Management and Geriatric Nursing, Daping Hospital, Chongqing, China
| | - Jing Deng
- Department of Respiratory and Critical Care Medicine, Southwest Hospital, Chongqing, China
- *Correspondence: Jing Deng
| | - Xia Xu
- Department of Health Management and Geriatric Nursing, Daping Hospital, Chongqing, China
- Xia Xu
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29
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Zhou Z, Jiang Y, Wu H, Jiang F, Yu Z. The Age of Mobility: Can Equalization of Public Health Services Alleviate the Poverty of Migrant Workers? Int J Environ Res Public Health 2022; 19:ijerph192013342. [PMID: 36293922 PMCID: PMC9603761 DOI: 10.3390/ijerph192013342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 05/26/2023]
Abstract
Migrants workers are important participants in and contributors to economic and social construction, but they still face the reality of being marginalized. Based on data from the China Migrants Dynamic Survey in 2018, this paper systematically investigated the impact of public health services on the multidimensional poverty of migrant workers. The research found that, first, the current mean of the multidimensional poverty deprivation value of migrant workers is 0.1806, which is one dimension of poverty that exists on average. In addition, migrant workers do not have high access to public health services. The proportions of migrant workers who have not established residents' health files and who have not received public health education are 74.22% and 29.92%, respectively. Second, public health services can significantly alleviate the multidimensional poverty of migrant workers. After mitigating the potential endogeneity problem by the IV-2SLS method and conducting robustness tests by the PSM method, the conclusion is still robust. Further research found that the impact of public health services on the multidimensional poverty alleviation of migrant workers is heterogeneous. The improvement of public health services has the greatest effect on the multidimensional poverty alleviation of the new generation of migrant female workers in the western region. The research in this paper helps to examine and clarify the policy significance of public health services for the multidimensional poverty alleviation of migrant workers and provides empirical evidence for the use of public health services to tackle the poverty problem.
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Affiliation(s)
- Ziming Zhou
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Yumeng Jiang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Haitao Wu
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Fan Jiang
- Institute of Agricultural Economics and Technology, Hubei Academy of Agricultural Science, Wuhan 430073, China
| | - Zhiming Yu
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
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Dong N, Wu X, Hong T, Shen X, Guo X, Wang H, Yu L, Zhao H, Fang Q. Elevated Serum Ninjurin-1 Is Associated with a High Risk of Large Artery Atherosclerotic Acute Ischemic Stroke. Transl Stroke Res 2022. [PMID: 36205878 DOI: 10.1007/s12975-022-01077-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 10/10/2022]
Abstract
Ninjurin-1 is a novel adhesion molecule which is involved in many inflammatory diseases. Functional blockage of Ninjurin-1 has exerted an atheroprotective effect. The aim of the study is to explore the association between serum Ninjurin-1 and the risk of large artery atherosclerotic acute ischemic stroke. From August 2020 through December 2021, patients with large artery atherosclerotic acute ischemic stroke (LAA-AIS) admitted to the First Hospital Affiliated to Soochow University, and age- and sex-matched controls free of ischemic stroke were recruited. Serum Ninj1 was measured with an enzyme-linked immunosorbent assay. Multivariable logistic regression models were used to calculate the odds ratios and 95% confidence intervals of LAA-AIS associated with serum Ninj1 levels, and receiver operating characteristic (ROC) curves were performed to assess the improvement value of Ninj1 for the prediction of LAA-AIS after adding Ninj1 to established risk factors. Of the 110 patients and 110 age- and sex-matched controls free of ischemic stroke enrolled, serum Ninj1 levels in LAA-AIS patients were significantly higher than that in control group (142.70 ng/ml [IQR: 110.41-163.44] vs 101.62 ng/ml [IQR: 86.63-120.86], p < 0.001). In multivariable analysis, Ninj1 levels were expressed as continuous variable and ordinal variable (tertiles), and it turned out that Ninj1 levels were positively associated with increased risk of LAA-AIS, especially in tertile3 compared with tertile1 (adjusted OR = 12.567, 95%CI: 5.148-30.678, p < 0.001), and the adjusted odds OR per 10 ng/ml increment was 1.541, 95%CI: 1.348-1.763, p < 0.001. Furthermore, adding Ninj1 to a multivariate logistic model including conventional risk factors associated LAA-AIS improved the area under ROC curves from 0.787 to 0.874. Elevated circulating levels of Ninj1 were associated with increased risk of LAA-AIS, indicating that serum Ninj1 may act as a predictor independent of established conventional risk factors.
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Ruan W, Liu C, Liao X, Guo Z, Zhang Y, Lei Y, Chen H. Development of a performance measurement system for general practitioners' office in China's primary healthcare. BMC Health Serv Res 2022; 22:1181. [PMID: 36131302 PMCID: PMC9491001 DOI: 10.1186/s12913-022-08569-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background General practitioners are the main providers of primary care services. To better strengthen the important role of general practitioners in primary healthcare services, China is promoting the general practitioners’ office system. There is a lack of well-accepted methods to measure the performance of general practitioner offices in China. We thus aim to develop a systematic and operable performance measurement system for evaluating the general practitioner’s office. Methods We establish an index pool of the performance measurement system of general practitioners’ offices by a cross-sectional study and the literature research method and adopt the focus group method to establish the preliminary system. The Delphi method is then used to conduct three rounds of consultation to modify indices, which aims to form the final indicator system. We determine the weight of each index by the analytic hierarchy process method, which together with the final indicator system constitutes the final performance measurement system. Finally, we select three offices from three different cities in Sichuan Province, China, as case offices to conduct the case study, aiming to assess its credibility. Results Our results show that the first office scored 958.5 points, the second scored 768.1 points, and the third scored 947.7 points, which corresponds to the reality of these three offices, meaning that the performance measurement system is effective and manoeuvrable. Conclusions Our study provides support for standardizing the functions of China’s general practitioner’s office, improving the health service quality of generalists, and providing a theoretical basis for the standardization of the general practitioner’s office. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08569-z.
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Affiliation(s)
- Wenjie Ruan
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Changming Liu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoxia Guo
- Business School, Sichuan University, Chengdu, 610065, China
| | - Yalin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Lei
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Huadong Chen
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
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Liu H, Yin Z, Chen S, Yang Y, Tian H. Development of an Assessment of Ethics for Chinese Physical Education Teachers: A Study Using the Delphi and Expert Ranking Methods. Int J Environ Res Public Health 2022; 19:11905. [PMID: 36231205 PMCID: PMC9565329 DOI: 10.3390/ijerph191911905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Developing the ethics of physical education (PE) teachers is important for promoting the overall development of students. However, it is unclear which indicators can be used to assess the ethics of PE teachers in China. Therefore, this study aimed to develop an assessment of ethics for Chinese physical education teachers (AECPET) using the Delphi and expert ranking methods. METHODS Two rounds of the Delphi method were performed to develop the assessment. An expert ranking method was used to determine the weight of each domain and indicator. RESULTS The developed AECPET is a multi-dimensional model with eight domains: (1) Policy Implementation (PI), (2) Legal Compliance and Patriotism (LCP), (3) Love for Students (LS), (4) Daily Performance (DP), (5) Philosophy of Educating Students (PES), (6) Attitude towards Scientific Research (ASR), (7) Awareness of Self-discipline and Honesty (ASH), and (8) Attitude towards Serving Society (ASS); and 42 indicators. The weight of PI, LCP, LS, DP, PES, ASR, ASH, and ASS are 18.1%, 19.1%, 16.2%, 11.1%, 16.3%, 7.2%, 9.1%, and 4.6%, respectively. CONCLUSIONS The AECPET is an evaluating system constructed based on the perspective of Chinese PE teachers, which also has a potentially global perspective and can be used by PE teachers with different cultural views. Applied by the government, schools, PE teachers, and students, the AECPET can improve the level of ethics of Chinese PE teachers.
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Affiliation(s)
- Haohui Liu
- College of Physical Education and Health, East China Normal University, Shanghai 200241, China
| | - Zhihua Yin
- College of Physical Education and Health, East China Normal University, Shanghai 200241, China
- Sports Postdoctoral Mobile Station, Tsinghua University, Beijing 100084, China
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Youcai Yang
- College of Physical Education and Health, East China Normal University, Shanghai 200241, China
| | - Hengxing Tian
- China Basketball College, Beijing Sports University, Beijing 100084, China
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Wang C, Yue Q, Xu T. Reducing Neonatal Mortality with a Three-Stage Neonatal Resuscitation Training Programme - China, 2004-2021. China CDC Wkly 2022; 4:807-810. [PMID: 36285280 PMCID: PMC9547731 DOI: 10.46234/ccdcw2022.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/28/2022] [Indexed: 11/12/2022] Open
Abstract
Neonatal asphyxia is a leading cause of neonatal death that is largely preventable with neonatal resuscitation techniques. In July 2004, China launched a 15-year, three-stage Neonatal Resuscitation Programme (NRP) with stages in 2004-2009, 2011-2016, and 2017-2021 ( 1). The objective of China's NRP was to ensure the presence of at least one trained attendant proficient in neonatal resuscitation at every delivery. With consistent effort, both incidence and mortality from neonatal asphyxia decreased remarkably during 2003-2020: incidence decreased from 6.32% to 1.42% and mortality decreased from 0.76‰ to 0.19‰ ( 1- 2). China's empirical experience shows that widespread promotion of high-quality neonatal resuscitation techniques can reduce preventable neonatal deaths and provide important insight into "ending preventable deaths in newborns by 2030," as proposed in the United Nations Sustainable Development Goal's third target ( 3).
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Affiliation(s)
- Chenran Wang
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qing Yue
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Xu
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China,Tao Xu,
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Qin S, Wang X, Li S, Tan C, Zeng X, Wu M, Peng Y, Wang L, Wan X. Benefit-to-harm ratio and cost-effectiveness of government-recommended gastric cancer screening in China: A modeling study. Front Public Health 2022; 10:955120. [PMID: 36033760 PMCID: PMC9399635 DOI: 10.3389/fpubh.2022.955120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/18/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Current guidelines recommend the gastric cancer risk score scale (GCRSS) for screening in gastric cancer (GC) high-risk populations in China. This study aimed to estimate the clinical benefits, harms, cost, and cost-effectiveness of the GCRSS screening strategy from a Chinese healthcare system perspective. Materials and methods Using a microsimulation model, we evaluated 7 screening scenarios of the GCRSS with varying starting ages. We simulated 100,000 individuals from the age of 20 for each screening scenario. The main outcomes included GC incidence reduction, number of cause-specific deaths, costs, quality-adjusted life year (QALY), incremental cost-effectiveness ratio (ICER), and benefit-to-harm ratio. Deterministic and probabilistic sensitivity analyses were done to explore the robustness of model findings. Results Screening with the GCRSS strategy at the age of 40 years (40-GCRSS) provided the greatest reduction of GC incidence by 70.6%, with 7,374 GC deaths averted per 100,000 individuals and the lowest benefit-to-harm ratio of 0.392. Compared with no screening or previous less costly strategy, at a willingness-to-pay (WTP) threshold of $37,655 per QALY, the 40-GCRSS strategy was cost-effective, with ICERs of $12,586 and $29,115 per QALY, respectively. Results were robust across univariate and probabilistic sensitivity analyses. The 40-GCRSS strategy showed a 0.856 probability of being cost-effective at a $37,655 per QALY WTP threshold. Conclusions The findings suggest that the GCRSS strategy is effective and cost-effective in reducing the GC disease burden in China from a Chinese healthcare system perspective. Screening from the age of 40 would be the optimal strategy.
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Affiliation(s)
- Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sini Li
- Xiangya Nursing School, Central South University, Changsha, China,School of Health and Related Research, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Liting Wang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Xiaomin Wan
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Chen L, Wang L, Qian Y, Chen H. Changes and Trend Disparities in Life Expectancy and Health-Adjusted Life Expectancy Attributed to Disability and Mortality From 1990 to 2019 in China. Front Public Health 2022; 10:925114. [PMID: 35923968 PMCID: PMC9339800 DOI: 10.3389/fpubh.2022.925114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aims to investigate sex, age, and cause-specific contributions to changes and trend disparities in life expectancy (LE) and health-adjusted life expectancy (HALE) attributed to disability and mortality from 1990 to 2019 in China, which provides insight into policy-making, health systems planning, and resource allocation. Methods Contributions of disability and mortality to changes and trend disparities in LE and HALE were estimated with standard abridged life table, Sullivan's method, and decomposition method, using retrospective demographic analysis based on mortality and years lived with disability (YLD) rates extracted from Global Burden of Disease Study 2019 (GBD 2019). Results From 1990 to 2019, LE and HALE increased by 10.49 and 8.71 years for both sexes, mainly due to noncommunicable diseases (NCDs) (5.83 years, 55.58% for LE and 6.28 years, 72.10% for HALE). However, HIV/AIDS and sexually transmitted infections had negative effects on changes in LE (−0.03 years, −0.29%) and HALE (−0.05 years, −0.57%). Lung cancer and ischemic heart disease caused the biggest reduction in LE (−0.14 years, −1.33%) and HALE (−0.42 years, −4.82%). Also, cardiovascular diseases (−0.08 years, −0.92%), neurological disorders (−0.08 years, −0.92%), diabetes and kidney diseases (−0.06 years, −0.69%), and transport injuries (−0.06 years, −0.69%) had main negative disability effects in HALE. Moreover, life expectancy lived with disability (LED) increased by 1.78 years, mainly attributed to respiratory infections and tuberculosis (1.04 years, 58.43%) and maternal and neonatal disorders (0.78 years, 43.82%). Conclusion The LE and HALE in China have grown rapidly over the past few decades, mainly attributed to NCDs. It is necessary to further reduce the negative mortality effect of HIV/AIDS, lung cancer, colon and rectum cancer, pancreatic cancer, and ischemic heart disease and the negative disability effect of stroke, diabetes mellitus, and road injuries. In addition, the signs of disparities in mortality and disability of different sexes and ages call for targeted and precise interventions for key groups such as males and the elderly. According to the decomposition results, we may better determine the key objects of health policies that take into account substantial cause-specific variations to facilitate the realization of “healthy China 2030” plan.
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Wang X, Gong XF, Xiong KX, Guo DS, Liu LJ, Lin CM, Chang WY. Mapping of Research in the Field of Forest Therapy-Related Issues: A Bibliometric Analysis for 2007-2021. Front Psychol 2022; 13:930713. [PMID: 35898977 PMCID: PMC9309728 DOI: 10.3389/fpsyg.2022.930713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Exposure to forest environments promotes human health. The number of relevant studies in this area has increased rapidly. However, an overall review of relevant analyses from the perspectives of bibliometrics and visualization is lacking. A scientometric analysis of 2,545 publications from 2007 to 2021 via the Web of Science database was conducted to identify the knowledge structure and frontiers objectively. The publications were subsequently analyzed in terms of the distribution of journals and countries, citation bursts, major subject areas, and evolutionary stages. The findings showed that the knowledge foundation of forest therapy was multidisciplinary with most published in the fields of environmental sciences and ecology but lacking input from social disciplines. The research hotspots evolved from the early focus on individual benefits obtained from nature to increasing attention on human well-being at the social-ecological scale. More rigorous experiments with strict randomized controlled trials and blinding are needed to accommodate the trend of forest therapy toward non-pharmacological treatments. According to Shneider's four-stage theory, forest therapy research is in the third stage of the scientific research process. More future studies utilizing novel technologies and decision-making frameworks to solve practical issues are needed for introducing health into policies and promoting human well-being.
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Affiliation(s)
- Xin Wang
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Xiang-Fei Gong
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Ke-Xin Xiong
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - De-Sheng Guo
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Li-Jun Liu
- Forest Therapy Branch, Chinese Society of Forestry, Beijing, China
| | | | - Wei-Yin Chang
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
- Forest Therapy Branch, Chinese Society of Forestry, Beijing, China
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Qin S, Wang X, Li S, Tan C, Zeng X, Luo X, Yi L, Peng L, Wu M, Peng Y, Wang L, Wan X. Clinical Benefit and Cost Effectiveness of Risk-Stratified Gastric Cancer Screening Strategies in China: A Modeling Study. Pharmacoeconomics 2022; 40:725-737. [PMID: 35701687 DOI: 10.1007/s40273-022-01160-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE A new gastric cancer screening scoring system (NGCS) strategy was recommended for the early gastric cancer (GC) screening process in China. The current study aimed to assess the clinical benefits and the cost effectiveness of the NGCS strategy in GC high-risk areas of China from a societal perspective. METHODS A Markov microsimulation model was developed to evaluate 30 alternative screening strategies with varying initiation age, including the NGCS strategy, the modified NGCS strategy, and the endoscopic screening strategy with various screening intervals. The primary outcomes included GC mortality, number of endoscopies, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Cost estimates were reported in 2021 USD (US$) and both costs and benefits were discounted at 5% annually. Deterministic and probabilistic sensitivity analyses were performed to evaluate model uncertainty. RESULTS Screening with the NGCS strategy from age 40 years (40-NGCS) reduced the GC incidence by 86.4%, which provided the greatest benefit across strategies. Compared with all strategies, at a willingness-to pay threshold of US$17,922 per QALY, the 40-NGCS strategy was a leading cost-effective strategy, with an ICER of US$15,668 per QALY. Results were robust in univariate and probabilistic sensitivity analyses. The probability of the 40-NGCS strategy being cost effective was 0.863. CONCLUSIONS The 40-NGCS strategy was an effective and cost-effective strategy to reduce GC incidence and mortality in China. The findings provide important evidence for decision makers to formulate and optimize targeted approaches for GC prevention and control policies in China.
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Affiliation(s)
- Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Sini Li
- Xiangya Nursing School, Central South University, Changsha, 410013, Hunan, China
- Faculty of Medicine, Dentistry and Health, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xia Luo
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Lidan Yi
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Liubao Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Liting Wang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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Nie Z, Xu H, Chen C, Gan Y, Chen G, Wang C, Yue W, Yan F, Feng Y, Lu Z. Population Attributable Risks of Potential Modifiable Factors for Atrial Fibrillation in China: A National Survey. Healthc Policy 2022; 15:1215-1224. [PMID: 35726314 PMCID: PMC9206524 DOI: 10.2147/rmhp.s360285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background There is an association between atrial fibrillation (AF) and overall mortality as well as mobility. It is not known, however, what the preventable burden of AF in China is. This study aims to identify what proportion of the burden of AF may be avoided by modifiable risk factors. Methods As part of the China National Stroke Screening and Prevention Project, 726,451 adults aged ≥40 years were enrolled in a representative cross-sectional study. The following seven factors have been categorized as modifiable risk factors for AF: body mass index, smoking, alcohol consumption, physical inactivity, hypertension, diabetes mellitus, and dyslipidemia. In order to calculate population-attributable risks (PARs), odds ratios (ORs) were calculated for selected risk factors. Results The crude ORs increased with age (ORs ranged from 1.92 to 4.02). A total of 18,736 cases of prevalent AF have been identified. The overall prevalence of AF was 2.6%. The crude ORs increased with age (ORs range 1.92–4.03). The adjusted ORs and the corresponding confidence intervals (CIs) for these seven modifiable factors were 1.16 (95% confidence interval [CI]: 1.12–1.19), 1.56 (95% CI: 1.49–1.62), 2.15 (95% CI: 2.02–2.28), 2.07 (95% CI: 2.01–2.14), 2.71 (95% CI: 2.62–2.79), 2.10 (95% CI: 2.02–2.19), 2.52 (95% CI: 2.44–2.60), and 3.32 (95% CI: 3.18–3.48), respectively. Accordingly, 59.3% of all cases of AF could be explained by having these modifiable risk factors, among which hypertension accounted for the greatest share. Conclusion In China, hypertension is the leading preventable cause of AF, and more than half of these cases can be prevented through improving those modifiable risk factors.
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Affiliation(s)
- Zhiqiang Nie
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.,Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Hongbin Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Chen Chen
- Department of Respiratory, Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Guo Chen
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, People's Republic of China
| | - Feng Yan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yingqing Feng
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Xu W, Lin J. Fiscal Decentralization, Public Health Expenditure and Public Health-Evidence From China. Front Public Health 2022; 10:773728. [PMID: 35664120 PMCID: PMC9157548 DOI: 10.3389/fpubh.2022.773728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Since the beginning of the COVID-19 outbreak and the launch of the "Healthy China 2030" strategy in 2019, public health has become a relevant topic of discussion both within and outside China. The provision of public health services, which is determined by public health expenditure, is critical to the regional public health sector. Fiscal decentralization provides local governments with more financial freedom, which may result in changes to public health spending; thus, fiscal decentralization may influence public health at the regional level. In order to study the effects of fiscal decentralization on local public health expenditure and local public health levels, we applied a two-way fixed effect model as well as threshold regression and intermediate effect models to 2008-2019 panel data from China's 30 mainland provinces as well as from four municipalities and autonomous regions to study the effects of fiscal decentralization on public health. The study found that fiscal decentralization has a positive effect on increasing public health expenditure. Moreover, fiscal decentralization can promote improvements in regional public health by increasing public health expenditure and by improving the availability of regional medical public service resources. In addition, fiscal decentralization has a non-linear effect on public health.
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Affiliation(s)
- Wangzi Xu
- School of Public Health, Xiamen University, Xiamen, China
| | - Jia Lin
- International School, Jinan University, Guangzhou, China
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Zhang YQ, Zhou MY, Jiang MY, Zhang XY, Wang X, Wang BG. Awareness of initiative practice for health in the Chinese population: A questionnaire survey based on a network platform. World J Clin Cases 2022; 10:5241-5252. [PMID: 35812685 PMCID: PMC9210912 DOI: 10.12998/wjcc.v10.i16.5241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In 2016, the Chinese government issued the Healthy China 2030 plan, which also produced the initiative practice for health (IPFH) concept. However, people’s knowledge and awareness of the IPFH are unclear.
AIM To investigate awareness of IPFH in the Chinese population and explore the relevant influential factors.
METHODS An internet-based self-designed questionnaire survey was used to collect respondents’ demographic characteristics and awareness of health and the IPFH from March 26 to April 18, 2020. IPFH consciousness was assessed by the scores for different related questions. The Student’s t test, the Chi-square test, and multiple logistic regression analysis were performed to analyze the differences and influencing factors.
RESULTS A total of 2678 valid questionnaires were collected. Of the respondents, 973 (36.3%) had heard of the IPFH concept. In addition, 89.5% of participants agreed with the view that the IPFH is beneficial to improving quality of life, and over half thought that a regular schedule, a reasonable diet, tobacco and alcohol control, a cheerful mood, specific life goals and plans, taking the initiative to accept health-related education and implement health knowledge, good interpersonal relationships, and regular physical examinations were closely related to the IPFH. The majority of respondents paid attention to their health and usually obtained health-related knowledge via social media and were also willing to promote the IPFH. Most of the participants underestimated the role of hospitals, family doctors, and health managers in promoting the IPFH. Age, monthly income, and medical-related work experience were the influencing factors for IPFH awareness.
CONCLUSION The Chinese population has limited knowledge of the IPFH. People with strong IPFH awareness are older, earn more, and have medical-related work experience.
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Affiliation(s)
- Yi-Qiang Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100095, China
| | - Ming-Yue Zhou
- Department of Subject Development, Sanbo Brain Hospital, Capital Medical University, Beijing 100095, China
| | - Meng-Yang Jiang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100095, China
| | - Xiao-Yu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xin Wang
- Department of Administrative Office, Sanbo Brain Hospital, Capital Medical University, Beijing 100095, China
| | - Bao-Guo Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100095, China
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Chen M, Li C, Liao P, Cui X, Tian W, Wang Q, Sun J, Yang M, Luo L, Wu H, Li YG. Epidemiology, management, and outcomes of atrial fibrillation among 30 million citizens in Shanghai, China from 2015 to 2020: A medical insurance database study. Lancet Reg Health West Pac 2022; 23:100470. [PMID: 35542895 PMCID: PMC9079299 DOI: 10.1016/j.lanwpc.2022.100470] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Atrial fibrillation(AF) has become a significant public health concern in China, with population aging and urbanization. METHODS Data screening was performed for 30,244,930 subjects with medical insurance in the Shanghai Municipal Health Commission database between 2015 and 2020. Patients diagnosed with AF were identified and further assessed for treatment information and clinical outcomes, as well as sex differences and impact of COVID-19 pandemic on AF managment. FINDINGS AF prevalence was 0.88% in Shanghai, which increased with age and reached 6.70% at subjects 80 years and over. AF was more prevalent in women compared with men (0.89% vs. 0.88%, p<0.0001), which could be attributed to higher AF burden in women over 80 years. Driven by increased prescription of non-vitamin K antagonist oral anticoagulants, anticoagulant use increased from 19.46% in 2015 to 56.57% in 2020. The number of left atrial appendage closure increased from 0.16% in 2015 to 1.23% in 2020. Rhythm control strategy was increasingly adopted, as the use of antiarrhythmic drugs doubled and ablation increased by 21% in 2020 compared to 2015. Compared with men, women were less prone to receive rhythm control treatments, including antiarrhythmics, ablation and cardioversion, but more likely to adopt rate control drugs. During the 5.5 years follow-up, the incidences of stroke, transient ischemic attack, systemic embolism, bleeding, myocardial infarction, and in-hospital death were 6.09%, 5.74%, 1.44%, 5.11%, 8.41%, and 12.84% in patients with index diagnosis of AF in 2015, respectively. INTERPRETATION The burdens of AF and AF-related outcomes in Shanghai are high. Management of AF is markedly improved in recent years, and was not or only slightly impeded by the COVID-19 pandemic. There are sex differences in the prevalence, management, and outcomes of AF. FUNDING Shanghai Hospital Development Center, National Natural Science Foundation of China and Shanghai Municipal Science and Technology Commission.
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Affiliation(s)
- Mu Chen
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peng Liao
- School of Public Health, Fudan University, Shanghai, China
| | - Xin Cui
- Shanghai Health Statistics Center, Shanghai, China
| | - Wenqi Tian
- Shanghai Health Statistics Center, Shanghai, China
| | - Qunshan Wang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Sun
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mei Yang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai, China
| | - Hong Wu
- Shanghai Municipal Health Commission
| | - Yi-Gang Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Corresponding author at: Yi-Gang Li, MD; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Road, Shanghai 200092, China.
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Gao Y, Zhu L, Mao ZJ. How to improve public health literacy based on polycentric public goods theory: preferences of the Chinese general population. BMC Public Health 2022; 22:921. [PMID: 35534809 PMCID: PMC9083483 DOI: 10.1186/s12889-022-13272-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background In the current era of big data, it is critical to address people’s demand for health literacy. At present, the traditional mode of communicating scientific health knowledge and information technology is interchangeable, resulting in the emergence of a new mode of communicating health literacy. To publicize health education and health literacy in a targeted way, to meet the public’s needs, and to understand how the public’s demand for subjects, contents, and forms of health literacy service has changed in the era of COVID-19, the investigation of public’s demand for health information and health literacy was conducted. Objective This study aims to understand the differences in demand for health literacy service providers, contents, channels, forms, and facilities among Chinese citizens with different genders, ages, education levels, economic conditions, and living environments, and to provide reasonable recommendations for developing public health literacy. Methods Questionnaire Star was used to conduct a large sample of random online surveys. In Wuhan, Hubei Province, 2184 questionnaires were issued, 8 invalid questionnaires were eliminated, and 2176 were recovered, with an effective rate of 99.6%. IBM SPSS Statistics 20 was utilized to analyze the survey data. Results (1) In health literacy service providers selected by the public, the proportion of government departments or government collaboration with other institutions exceeded 73%, indicating that health literacy services are public goods; (2) access to health literacy services was lower in township areas than in urban areas (P < 0.001, 3) internet media and communicating with acquaintances, which have the highest popularity rate, were also the two channels that were least trusted by the public; and (4) the differences in contents and service channels of health literacy among residents with different genders, ages, education levels, economic status, and living environments were statistically significant. Conclusions (1) It is recommended to establish an integrated health literacy service model with multi-center supply. Government departments, medical institutions, and media should cooperate effectively to provide health literacy services. (2) The government should pay attention to the fairness of health education and strengthen the supply of health literacy services in township areas. (3) It is critical to strengthen the public’s ability to discriminate network information and pay attention to scientific thinking cultivation. (4) Health literacy service providers must focus on the differences between public demands and improve the connotation of health literacy services. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13272-z.
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Affiliation(s)
- Yaxin Gao
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Ave, Wuhan, No. 1095, China.,College of Public Administration, Huazhong University of Science and Technology, No 1037 Luau Road, Hongshan District, Wuhan, 430074, China.,Non-traditional Security Institute, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Li Zhu
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Ave, Wuhan, No. 1095, China
| | - Zi Jun Mao
- College of Public Administration, Huazhong University of Science and Technology, No 1037 Luau Road, Hongshan District, Wuhan, 430074, China. .,Non-traditional Security Institute, Huazhong University of Science and Technology, Wuhan, 430074, China.
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Zheng X, Xue Y, Dong F, Shi L, Xiao S, Zhang J, Xue B, Qian Y, Zhu H, Man Q, Zhang C. The association between health-promoting-lifestyles, and socioeconomic, family relationships, social support, health-related quality of life among older adults in china: a cross sectional study. Health Qual Life Outcomes 2022; 20:64. [PMID: 35443689 PMCID: PMC9022255 DOI: 10.1186/s12955-022-01968-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/29/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of older adults. Thus, this study aimed to explore the influencing factors of the health-promoting-lifestyles and interaction mechanisms among older adults. Methods A total of 8526 elders were selected by a three-stage stratified random cluster sampling method. Socioeconomic status, family relationships, social support, health-related quality of life (QOL), and health-promoting-lifestyles (HPLP) of older adults were assessed with the Social Support Rating Scale, the short form 36 health survey (SF-36) and Health-Promoting Lifestyle Profile. A structural equation model (SEM) was conducted to test the direct and indirect association between influencing factors with HPLP. Results In this study, there were 4901 older adults who were empty nesters, and 3625 were non-empty nesters. Of all respondents, the average QOL score of older adults was 62.28 ± 16.51, average social support score was 78.06 ± 7.50. The HPLP score of older adults was 105.9 ± 19.6, and the average score of subscales was 2.5 ± 0.5, which was at the medium level. Social support had a positive and direct effect on HPLP of older adults (total effect, 0.34). Meanwhile, social support mediated the relationship between socioeconomic (total effect, 0.17), QOL (total effect, 0.33) and HPLP. Family relationships had a small indirect effect on HPLP via social support (0.01). Conclusions Social support is the strongest influencing factor in the health-promoting-lifestyles among older adults, followed by socioeconomic, health-related quality of life and family support. Thus, maintaining higher social support was important to improve the HPLP of older adults.
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Affiliation(s)
- Xiao Zheng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Fang Dong
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Yi Qian
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Hong Zhu
- Institute of Health Management Southern Medical University, Guangzhou, Guangdong, China
| | - Qiang Man
- School of International Education, Southern Medical University, Guangzhou, Guangdong, China.
| | - Chichen Zhang
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China. .,Institute of Health Management Southern Medical University, Guangzhou, Guangdong, China. .,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Su K, Yuan J, Liu H, Luo M, Li Q, Liu S, Feng X. The Comparative Effectiveness of Traditional Chinese Medicine Exercise Therapies in Elderly People With Mild Cognitive Impairment: A Systematic Review and Network Meta-Analysis. Front Neurol 2022; 13:775190. [PMID: 35370918 PMCID: PMC8966650 DOI: 10.3389/fneur.2022.775190] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mild cognitive impairment (MCI) in the elderly is a health problem worldwide. Studies have confirmed that traditional Chinese medicine (TCM) exercise therapies can improve MCI. However, which therapy is the best and their impacts on brain function remain controversial and uncertain. This study aims to compare and rank TCM exercise therapies for MCI in the elderly, and analyze their effects on brain function, in order to find an optimal intervention and provide a basis for clinical treatments decision-making. Methods The Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure (CNKI), Wangfang database, China Science and Technology Journal Database, and Chinese Biomedical Medicine (CBM) were searched through October 28, 2021. Two researchers reviewed all the studies and extracted the data. The ADDIS software version 1.16.8 and the Bayesian hierarchical model were used for pair-wise meta-analysis and network meta-analysis, and the STATA software version 14.0 was used to draw the network evidence plots and funnel plots. Results A total of 23 studies on 2282 participants were included in this study. In the pair-wise meta-analysis, TCM exercise therapies (Baduanjin exercise, Tai Chi, Liuzijue exercise and finger exercise) were superior to non-TCM exercise therapies (stretching and toning exercise, usual care, health education and routine daily activities) in terms of MMSE, MoCA and ADL outcomes. In the network meta-analysis, the MMSE outcome ranked Baduanjin exercise (78%) as the best intervention and Tai Chi (36%) as the second. The MoCA outcome ranked Baduanjin exercise (62%) as the best intervention. For the ADL outcome, Baduanjin exercise (60%) ranked the best, and followed by finger exercise (43%). Conclusion TCM exercise therapies may improve the cognitive function in elderly patients with MCI. Among the four therapies included, the Baduanjin exercise may be the preferred therapy for MCI in the elderly, and its mechanism may be related to the regulation of cognitive-related brain function and structure. Systematic Review Registration https://inplasy.com, identifier: INPLASY202070006.
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Affiliation(s)
- Kaiqi Su
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jie Yuan
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Huanhuan Liu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Meng Luo
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Qi Li
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Sutong Liu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaodong Feng
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Du K, Zheng X, Ma ZT, Lv JY, Jiang WJ, Liu MY. Association of Circulating Magnesium Levels in Patients With Alzheimer's Disease From 1991 to 2021: A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 13:799824. [PMID: 35082658 PMCID: PMC8784804 DOI: 10.3389/fnagi.2021.799824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease (AD) remains a medical and social challenge worldwide. Magnesium (Mg) is one of the most frequently evaluated essential minerals with diverse biological functions in human body. However, the association between circulating Mg levels and AD remains controversial. We conducted a meta-analysis of 21 studies published between 1991 and 2021 to determine whether the Mg levels in the blood and cerebrospinal fluid (CSF) are abnormal in AD. Literatures were searched in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data without language limitations. A pooled subject sample including 1,112 AD patients and 1,001 healthy controls (HCs) was available to assess Mg levels in serum and plasma; 284 AD patients and 117 HCs were included for Mg levels in CSF. It was found that serum and plasma levels of Mg were significantly reduced in AD patients compared with HCs (standardized mean difference [SMD] = -0.89; 95% confidence interval [CI] [-1.36, -0.43]; P = 0.000). There was statistically non-significant for Mg level in CSF between AD and HCs, whereas a decreased tendency were detected (SMD = -0.16; 95% CI [-0.50, 0.18]; P = 0.364). .In addition, when we analyzed the Mg levels of serum, plasma and CSF together, the circulating Mg levels in AD patients was significantly lower (SMD = -0.74, 95% CI [-1.13; -0.35]; P = 0.000). These results indicate that Mg deficiency may be a risk factor of AD and Mg supplementation may be a potentially valuable adjunctive treatment for AD. Systematic Review Registration: www.crd.york.ac.uk/PROSPERO/, registration number CRD42021254557.
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Affiliation(s)
- Ke Du
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
| | - Xi Zheng
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
| | - Zi-Tai Ma
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
| | - Jun-Ya Lv
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
| | - Wen-Juan Jiang
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ming-Yan Liu
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
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Wang Y, Wang X, Liao K, Luo B, Luo J. The burden of endometriosis in China from 1990 to 2019. Front Endocrinol (Lausanne) 2022; 13:935931. [PMID: 36051388 PMCID: PMC9424490 DOI: 10.3389/fendo.2022.935931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/25/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The trends in deaths from and disability-adjusted life years (DALY) of endometriosis in China remain largely unknown. This study revealed these trends and the effects of age, period, and cohort on the death from and DALY of endometriosis in China from 1990 to 2019. METHODS Data on endometriosis death and DALY in China between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 (GBD 2019). The annual percentage change and average annual percent change (AAPC) were analyzed by joinpoint regression. The effects of age, period, and birth cohort on death and DALYs were estimated using an age-period-cohort analysis. RESULTS The age-standardized death rate (ASDR) and age-standardized DALY rate for endometriosis significantly decreased in China, with AAPC values of -4.7 (95% confidence interval [CI]: -5.10, -4.30) and -1.2 (95% CI: -1.20, -1.10), respectively. The joinpoint regression analysis showed that the ASDR and age-standardized DALY rate decreased across all age groups. Moreover, the effect of age on endometriosis death and DALY decreased with advancing age. Both the period and cohort effects on endometriosis death and DALY showed decreasing trends, with the effects on death decreasing faster than the effects on DALY. CONCLUSIONS The endometriosis ASDR and age-standardized DALY rate decreased from 1990 to 2019. The effects of the period and birth cohort on endometriosis death and DALY showed a declining trend across all age groups. The effect of age on endometriosis deaths and DALYs decreased with advancing age.
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Chen J, Lin Z, Li LA, Li J, Wang Y, Pan Y, Yang J, Xu C, Zeng X, Xie X, Xiao L. Ten years of China's new healthcare reform: a longitudinal study on changes in health resources. BMC Public Health 2021; 21:2272. [PMID: 34903184 PMCID: PMC8670033 DOI: 10.1186/s12889-021-12248-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China's health resources over the past ten years after the healthcare reform. METHODS Data were collected from the China Statistical Yearbook and China Health Statistics Yearbook from 2009 to 2018. Four categories and ten indicators of health resources were analyzed. A descriptive analysis was used to present the overall condition. The Health Resource Density Index was applied to showcase health-resource distribution in demographic and geographic dimensions. The global and local Moran's I were used to assess the spatial autocorrelation of health resources. Concentration Index (CI) was used to quantify the equity of health-resource distribution. A Geo-Detector model and Geographic Weighted Regression (GWR) were applied to assess the association between gross domestic product (GDP) per capita and health resources. RESULTS Health resources have increased over the past ten years. The global and local Moran's I suggested spatial aggregation in the distribution of health resources. Hospital beds were concentrated in wealthier areas, but this inequity decreased yearly (from CI=0.0587 in 2009 to CI=0.0021 in 2018). Primary medical and health institutions (PMHI) and their beds were concentrated in poorer areas (CI remained negative). Healthcare employees were concentrated in wealthier areas (CI remained positive). In 2017, the q-statistics indicated that the explanatory power of GDP per capita to beds, health personnel, and health expenditure was 40.7%, 50.3%, and 42.5%, respectively. The coefficients of GWR remained positive with statistical significance, indicating the positive association between GDP per capita and health resources. CONCLUSIONS From 2009 to 2018, the total amount of health resources in China has increased substantially. Spatial aggregation existed in the health-resources distribution. Health resources tended to be concentrated in wealthier areas. When allocating health resources, the governments should take economic factors into account.
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Affiliation(s)
- Jiang Chen
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuochen Lin
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li-An Li
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Li
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuyao Wang
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Pan
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jie Yang
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuncong Xu
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaojing Zeng
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxu Xie
- School of Public Health, Fujian Medical University, Fuzhou, China.
| | - Liangcheng Xiao
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Feng J, Zhang S, Chen J, Yang J, Zhu J. Long-term trends in the incidence of endometriosis in China from 1990 to 2019: a joinpoint and age-period-cohort analysis. Gynecol Endocrinol 2021; 37:1041-1045. [PMID: 34519590 DOI: 10.1080/09513590.2021.1975675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Trends in the incidence of endometriosis in China remain unknown. The purpose of this study was to examine the trends in the incidence of endometriosis and the effects of age, period, and cohort on them. METHODS Trends in endometriosis incidence were estimated using joinpoint regression. Age-period-cohort analysis was used to analyze the effects of age, period, and cohort on these trends. Endometriosis incidences in China (1990-2019) were retrieved from the Global Burden of Disease Study 2019. Annual percentage change and average annual percent change (AAPC) were analyzed by joinpoint regression, and relative risks were analyzed using an age-period-cohort model. RESULTS Age-standardized incidence rates (ASIRs) declined between 1990 and 2019 in China, with an overall AAPC of -1.2% (95% CI: -1.20, -1.10). Compared to 1990, the ASIR in 2019 decreased by almost 30%. Moreover, the joinpoint regression analysis revealed that endometriosis ASIRs showed a downward trend across all age groups. A significant age-related effect was seen for endometriosis incidence among young women aged 15-24 years, which then decreased with advancing age. Consistently, the effect of the period on endometriosis incidence showed a declining trend, and the effect of birth cohort decreased by 0.53 (42.7%) from 1938-1942 to 1998-2002. CONCLUSIONS Endometriosis ASIRs declined from 1990 to 2019. The effects of period and birth cohort on endometriosis incidence exhibited a declining trend across all age groups. The effect of age on endometriosis incidence showed an increasing trend before the age of 24, followed by a decreasing trend with subsequent advancing age.
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Affiliation(s)
- Jinhui Feng
- The Third Department of Gynecology, Ningbo Women & Children's Hospital, Ningbo, China
| | - Shitong Zhang
- The Third Department of Gynecology, Ningbo Women & Children's Hospital, Ningbo, China
| | - Jiadong Chen
- The Third Department of Gynecology, Ningbo Women & Children's Hospital, Ningbo, China
| | - Jie Yang
- The Third Department of Gynecology, Ningbo Women & Children's Hospital, Ningbo, China
| | - Jue Zhu
- The Third Department of Gynecology, Ningbo Women & Children's Hospital, Ningbo, China
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Abstract
Background Pancreatic cancer is an aggressive cancer and is predicted to become the second leading cause of cancer-related deaths in China. To understand the epidemic trend of pancreatic cancer and formulate targeted preventive measures, it is important to analyze the incidence and mortality of pancreatic cancer. Methods The incidence and mortality data of pancreatic cancer in China were obtained from Global Burden of Disease (GBD) data. We used joinpoint regression analysis to calculate the magnitude and direction of trends, and the age-period-cohort method to analyze the effects of chronological age, time period, and birth cohort. Results The age-standardized rates (ASRs) for both incidence and mortality of pancreatic cancer increased from 1990 to 2019, and were higher in males than females. The incidence and mortality rates have increased year by year in the age group above 25 years. The most common age group was 55–79 years, accounting for approximately 50% of all incident cases. In terms of incidence and mortality rates, the overall net drifts were above 0. The local drifts in all age groups were above 0 in both sexes and males, while the local drifts in the 15–39 age groups were below 0 in females. The longitudinal age curves increased with age, with higher incidence and mortality rates, mainly in older age groups. The period rate ratios increased by year. The cohort rate ratios showed an upward trend before 1970 and fluctuated after 1975. Conclusions The burden of pancreatic cancer is still very high in China, and attention should be paid to the key population that is, males and older people. The results of our study can be used by policy makers to allocate resources efficiently to improve early diagnosis and treatment, improving the awareness of self-protection, and advocating a healthy lifestyle to prevent pancreatic cancer.
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Affiliation(s)
- Bo Zhu
- Department of Cancer Prevention and Treatment, Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Tianyu Guo
- Department of Hepatobiliary surgery, 74665Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Ning Guan
- Center of medical examination, 74665Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Yefu Liu
- Department of Hepatobiliary surgery, 74665Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
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