Community-embedded follow-up management intervention for geriatric primary care: a mixed-methods study of an integrated health services model.

BACKGROUND: To propose a community-embedded follow-up management model to provide health services for elderly patients with osteoporosis who live alone. METHODS: Researchers randomly selected 396 people with osteoporosis living alone from five communities in Nantong, China, for the study. These participants were randomly assigned to control and intervention groups. Twenty-four community physicians in five communities provided professional support based on a community-embedded follow-up management model. Participants completed quantitative questionnaires at baseline and after the 6-month follow-up intervention, and some participants underwent semi-structured face-to-face interviews. The primary outcome is the effectiveness of the community-embedded follow-up management model in improving the quality of life of elderly patients with osteoporosis living alone. Based on an objective quantitative assessment, the qualitative study explains and adds essential components of this community-based follow-up management model. RESULTS: The quantitative study showed that scores in physical functioning, ability to perform daily activities, self-efficacy, and mental status were significantly improved in the intervention group compared to the control group (p < 0.05). The most significant improvements were found in "mental status" (p = 0.012) and "self-care skills" (p = 0.003). The qualitative study reported the essential elements of a community healthcare model for older people living alone with osteoporosis, including professional support, personalized services, social support, and empowerment. CONCLUSIONS: Community-embedded follow-up management meets the need for elderly patients with osteoporosis living alone. It helps to improve health perception, promote physical and mental health, and optimize the quality of life in this population. Personalized services and professional support are two major contributing factors to effective embedded follow-up management in the community.

Evaluation of the Effectiveness of Remote Monitoring to Establish a Community Health Intervention During COVID-19: A Community Intervention Trial.

Background: The widespread use of telemedicine systems and medical information networks has made telemedicine one of the current trends in health care. The purpose of this article is to propose a community health intervention with remote monitoring and teleconsultation during COVID-19 for the prevention and control of COVID-19 at the rural level. Methods: In this intervention study, a randomized group of 1,500 community residents was selected. A questionnaire with acceptable validity and reliability was used to collect data. The study was conducted with the test group itself as a control, and the questionnaire was completed again 6 months after the health intervention through remote monitoring. The extent of the effect of the remote monitoring intervention on community health during COVID-19 was measured. The data were entered into SPSS 26, and the data were analyzed using the K-S normality test, t-test, and chi-square test. Results: After 6 months of the intervention, the differences in mean scores of the test group were statistically significant (p < 0.05) in cognition, perceived benefits, self-efficacy, and behavioral outcomes, with a substantial increase in mean scores for all variables. Conclusions: The application of remote monitoring during COVID-19 in rural communities can influence the health perception, benefit perception, self-efficacy, and behavior of community residents, thus effectively preventing and controlling the spread of COVID-19 in rural communities. It reduces medical barriers for rural areas while meeting.

Estimating environmental co-benefits of U.S. low-carbon pathways using an integrated assessment model with state-level resolution.

There are many technological pathways that can lead to reduced carbon dioxide emissions. However, these pathways can have substantially different impacts on other environmental endpoints, such as air quality and energy-related water demand. This study uses an integrated assessment model with state-level resolution of the energy system to compare environmental impacts of alternative low-carbon pathways for the United States. One set of pathways emphasizes nuclear energy and carbon capture and storage, while another set emphasizes renewable energy, including wind, solar, geothermal power, and bioenergy. These are compared with pathways in which all technologies are available. Air pollutant emissions, mortality costs attributable to particulate matter smaller than 2.5 µm in diameter, and energy-related water demands are evaluated for 50% and 80% carbon dioxide reduction targets in 2050. The renewable low-carbon pathways require less water withdrawal and consumption than the nuclear and carbon capture pathways. However, the renewable low-carbon pathways modeled in this study produce higher particulate matter-related mortality costs due to greater use of biomass in residential heating. Environmental co-benefits differ among states because of factors such as existing technology stock, resource availability, and environmental and energy policies.

Projecting state-level air pollutant emissions using an integrated assessment model: GCAM-USA.

Integrated Assessment Models (IAMs) characterize the interactions among human and earth systems. IAMs typically have been applied to investigate future energy, land use, and emission pathways at global to continental scales. Recent directions in IAM development include enhanced technological detail, greater spatial and temporal resolution, and the inclusion of air pollutant emissions. These developments expand the potential applications of IAMs to include support for air quality management and for coordinated environmental, climate, and energy planning. Furthermore, these IAMs could help decision makers more fully understand tradeoffs and synergies among policy goals, identify important cross-sector interactions, and, via scenarios, consider uncertainties in factors such as population and economic growth, technology development, human behavior, and climate change. A version of the Global Change Assessment Model with U.S. state-level resolution (GCAM-USA) is presented that incorporates U.S.-specific emission factors, pollutant controls, and air quality and energy regulations. Resulting air pollutant emission outputs are compared to U.S. Environmental Protection Agency 2011 and projected inventories. A Quality Metric is used to quantify GCAM-USA performance for several pollutants at the sectoral and state levels. This information provides insights into the types of applications for which GCAM-USA is currently well suited and highlights where additional refinement may be warranted. While this analysis is specific to the U.S., the results indicate more generally the importance of enhanced spatial resolution and of considering national and sub-national regulatory constraints within IAMs.

[Clinical analysis of 105 extremely low birth weight infants].

OBJECTIVE: To explore the changes of outcome and morbidity in extremely low birth weight (ELBW) infants. METHODS: A retrospective study was performed for ELBW infants admitted into Children's Hospital, Fudan University within 24 hours after birth from January 2007 to December 2011. The maternal and neonatal data were collected by reviewing the medical charts and entered into the dataset. RESULTS: A total of 105 ELBW infants (54 males, 51 females) were enrolled. The average gestational age was (28.4 ± 2.6)weeks and birth weight was (860 ± 121)g. Neonatal respiratory syndrome (NRDS) (n = 89, 84.8%), apnea(n = 58, 55.2%), sepsis (n = 47, 44.8%) and patent ductus arteriosus (n = 46, 43.8%) remained their major complications.Sepsis was the commonest cause of mortality (7/17) excluding social factors. The incidence of extrauterine growth restriction (46/51, 90.2%) was significantly high at discharge. And the use of antenatal steroids was merely 40.8% (42/103) in ELBW infants at a gestation age under 34 weeks. CONCLUSIONS: The number of ELBW infants has increased dramatically. Antenatal steroids, noninvasive respiratory support, prevention of infections and optimal nutrition supports are key factors of improving the survival rate, short and long-term outcomes of ELBW infants.