Cross-sectional study on dysphagia evaluation in community-dwelling older adults using the Eating Assessment Tool (EAT) -10, EAT-2, and Water Swallow Test.

BACKGROUND: Dysphagia is a health concern that causes severe complications and affects the life quality of the older population. This study aimed to determine the diagnostic performance of the Eating Assessment Tool (EAT)-2 compared with the EAT-10 and the Water Swallow Test (WST) in screening for dysphagia. METHODS: A cross-sectional study was conducted among 5,090 community-dwelling older adults. Dysphagia was evaluated using both a subjective measure, the 10-item EAT (EAT-10) and an objective measure, the WST. The kappa index in pairs were analyzed. The validity and reliability of EAT-2 were also assessed. RESULTS: The sensitivity and specificity of the EAT-2 were 96.3 % and 94.8 %, respectively. The kappa index between the EAT-2 and EAT-10 was 0.64, whereas it was 0.11 between the EAT-10 and WST. CONCLUSIONS: The EAT-2 was a simpler screening tool for dysphagia. Combining the subjective questionnaire (EAT-10 or EAT-2) and the objective test (WST) is recommended.

Regression-based normative data for social health scale for the elderly (short version) in eastern China.

BACKGROUNDS: Social Health Scale for the Elderly short version (SHSE-S) is a psychometrically sound instrument that comprehensively assesses the social health status of older adults in China. The aim of the present study was to establish continuous normative data of SHSE-S. METHODS: We conducted a multicenter cross-sectional study among 31 communities in eastern China. Older adults aged 60 years and above were invited to participate in the study. Each participant was interviewed in-person to finish a structured questionnaire. The SHES-S score was calculated and standardized for each participant. We split the sample into generation and validation datasets and compared the distribution of SHSE-S score between two datasets. Multivariable linear regression was used to assess the SHSE-S score and demographic variables. Regression-based norms were built using a four-step process. RESULTS: A total of 6089 participants (51.2% females) aged 60 years old and above (mean age = 71.3, SD = 8.0) were enrolled as the normative sample. No significant difference was found between the distribution of SHSE-S standardized score in the generation (N = 2392) and validation (N = 3697) datasets. Multivariable linear regression showed that females, higher education levels were positive indicators while aging, living alone, divorced or never married, multimorbidity were negative factors. The regression-based norm which taking demographic factors into account was established and a user-friendly worksheet was also provided to facilitate the scoring and norming of the SHSE-S. CONCLUSIONS: The population-based regression norm of SHSE-S can be a useful tool for assessing the social health status of the Chinese elderly population.

Multicenter biomonitoring of polybrominated diphenyl ethers (PBDEs) in colostrum from China: Body burden profile and risk assessment.

Polybrominated diphenyl ethers (PBDEs) were listed in the Stockholm Convention due to their persistent and toxic nature. In utero exposure to PBDEs might affect fetal development as it is sensitive when exposed to even low dose of xenobiotic substances during the pregnancy. In this study, a multi-centre human biomonitoring study of tri-to hexa-BDEs was conducted in three Chinese cities using 60 colostrum samples from local residents. The patterns and influencing factors, correlation with the birth outcome, and potential health risks during the breastfeeding of tri-to hexa-BDEs in the colostrum samples were assessed. The median concentration of tri-to hexa-BDEs was 9.1 (Interquartile range: 3.1-19.5) ng g-1 lipid weight, and BDE-153 contributed 68% of the detected PBDEs. The PBDE levels were mostly associated with maternal age and drinking water sources, while correlations with other factors including weight gain, BMI, parity and the number of aborted pregnancies was not significant. The level of BDE-28 was positively correlated with the birth weight, while the BDE-99 was positively correlated with the head circumference, using multilinear regression. For the total hazard quotients, 60% of the infants have an estimated value higher than 1, showed potential chronic hazard for future development and possible adverse health effects to the babies from the exposure to PBDE congeners. Alternative food source seems to have a lower risk for neonates than the colostrum, but the advantages of breastfeeding undoubtedly outweigh the risks and potential adverse health effects caused by environmental PBDEs and other xenobiotic chemical exposure.

The development of the social health scale for the elderly.

BACKGROUND: With the elderly population comprising an increasing large proportion of society, a valid and reliable measure of social health in the elderly is indispensable for a comprehensive health assessment. The objective of this study is to develop a Social Health Scale for the Elderly (SHSE). METHODS: A draft scale was generated based on a literature review and expert surveys. Pilot testing was conducted from December 14, 2015, to January 8, 2016. Some items were removed after assessment with five statistical analysis methods. Field testing began on November 6, 2016, and ended on January 20, 2017. After field testing, the reliability and validity of the scale were assessed and the norms in Hangzhou were calculated. RESULTS: In the two tests, 430 and 2404 subjects were included in the statistical analyses. The long form of the SHSE (SHSE-L) contained 25 items, 14 of which were also in the short form (SHSE-S). The internal consistency of the SHSE-L was acceptable. The test-rest reliability and inter-rater reliability were moderate, but the concurrent validity, construct validity, and convergent and discriminant validity were desirable in both versions. The standard and percentile rank norms in Hangzhou, China were developed based on the field testing data. CONCLUSIONS: The population-based social health of the Chinese elderly can be validly and reliably assessed with the SHSE.

Assessment of arsenic in colostrum and cord serum and risk exposure to neonates from an island population in China.

Arsenic (As) has been proven to be highly toxic to humans, but limited attention has focused on exposure levels and potential risks to mother-neonate pairs of coastal populations. This study was conducted by examining the As concentration in colostrum and umbilical cord serum collected from 106 mother-neonate pairs living on Shengsi Island, facing the Yangtze River estuary and Hangzhou Bay in China. Average concentrations of total As in colostrum and cord serum were 18.51 ± 7.00 and 19.83 ± 10.50 µg L-1. One-way ANOVA analysis showed delivered ages and source of drinking water played significant roles in influencing the maternal exposure patterns. Correlation analysis indicated a significantly positive association between As concentrations in colostrum and cord serum. Multivariable linear regression models adjusted for other confounders clarified the dose-response relationship with a coefficient value of 0.23 and a 95 % confidence interval of (0.006, 0.492); p < 0.05. The calculated daily intake of total As for neonates through breastfeeding was in the range from 0.413 to 3.65 µg kg-1 body weight, and colostrum As, especially the most toxic species, inorganic arsenic (iAs), would pose a risk to neonates.

Status, influences and risk assessment of hexachlorocyclohexanes in agricultural soils across china.

Large amounts of hexaclorocyclohexanes (HCHs) were historically applied to Chinese soils. However, there has been limited information on the residue patterns of HCHs in soils at a national scale in China. In this study, surface soil samples were collected from agricultural fields across China, and the concentrations of HCHs and enantiomeric fractions (EFs) of α-HCH were measured. The results showed that the average concentrations of α-HCH, ß-HCH, γ-HCH, and total HCHs in Chinese agricultural soils were 0.190, 1.31, 0.236, and 1.74 ng g(-1), respectively. Residues of HCHs likely originated from past usage of technical HCHs. The isomers of α-HCH and γ-HCH tended to accumulate in the sites with lower total HCH concentrations, lower temperature, higher elevation, and less wet precipitation when compared to ß-HCH. Enantiomeric analysis showed a preferential degradation of (-)-α-HCH. Human health risks via various exposure routes to HCHs in soils were further estimated. Overall, the mean hazard index (HI) linked to noncarcinogenic risks was below 1, suggesting an absence of noncarcinogenic risks of HCHs in Chinese soils. In addition, the cancer risk values were all below 10(-4), which indicates low or very low risks.