Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Percepção sobre abandono afetivo em idoso institucionalizado / Perception of emotional neglect in institutionalized elderly / Percepción del abandono afectivo en adultos mayores institucionalizado

Objetivo: Compreender a percepção dos idosos institucionalizados quanto ao abandono afetivo por parte de seus familiares.Método: Trata-se de um estudo exploratório, comabordagemqualitativa. Conduzido por meio de entrevistas semiestruturadas. A organização e análise dos dados foram baseadas na técnica de Minayo. O estudo foi realizado em uma Instituição de Longa Permanência para Idosos, localizada em uma cidade do nordeste de Santa Catarina.Resultados: Participaram do estudo nove idosos, com idades entre 60 e 89 anos, com diferentes estados civis (viúvos, casados e divorciados), variando sua escolaridade do nível básico ao superior, além de serem aposentados ou pensionistas. Foram identificadas quatro categorias analíticas: (1) vivência na instituição, (2) motivos para a institucionalização, (3) relacionamento familiar e (4) percepção do abandono familiar.Conclusão: alguns idosos enfatizaram sentir-se esquecidos na instituição, o que os deixa tristes e deprimidos. É crucial para a prática de a enfermagem compreender a realidade dos idosos nas Instituições de Longa Permanência, pois essa compreensão está diretamente ligada à prestação de cuidados em todos os níveis de assistência à saúde

Objective: To understand the perception of institutionalized elderly individuals regarding the emotional abandonment by their family members.Methodology: This is an exploratory study, using qualitative methods. Conducted through semi-structured interviews. Data organization and analysis were based on Minayo's technique. The study was conducted at a Long-Term Care Institution for the Elderly located in a city in northeastern Santa Catarina.Results: Nine elderly individuals participated in the study, ranging in age from 60 to 89 years old, with different marital statuses (widowed, married, and divorced), ranging in education from basic to higher levels, and being retirees or pensioners. Four analytical categories were identified: (1) experience in the institution, (2) reasons for institutionalization, (3) family relationships, and (4) perception of family abandonment.Conclusion: Some elderly individuals emphasized feeling forgotten in the institution, which makes them feel sad and depressed. Understanding the reality of the elderly in Long-Term Care Institutions is crucial for nursing practice, as this understanding is directly linked to providing care at all levels of healthcare assistance in the Health Care Network

Objetivo: Comprender la percepción de las personas mayores institucionalizadas con respecto al abandono afectivo por parte de sus familiares. Metodología:Se trata de un estudio exploratorio, utilizando métodos cualitativos. Realizado a través de entrevistas semiestructuradas. La organización y análisis de los datos se basaron en la técnica de Minayo. El estudio se llevó a cabo en una Institución de Larga Estadía para Personas Mayores lubicada en una ciudad del noreste de Santa Catarina. Resultados:Nueve personas mayores participaron en el estudio, con edades comprendidas entre 60 y 89 años, con diferentes estados civiles (viudos, casados y divorciados), variando en educación desde niveles básicos hasta superiores, y siendo jubilados o pensionistas. Se identificaron cuatro categorías analíticas: (1) experiencia en la institución, (2) motivos para la institucionalización, (3) relaciones familiares y (4) percepción del abandono familiar. Conclusión:Algunas personas mayores enfatizaron sentirse olvidadas en la institución, lo que los hace sentir tristes y deprimidas. Es crucial para la práctica de enfermería comprender la realidad de los adultos mayores en las Instituciones de Larga Estancia, ya que esta comprensión está directamente vinculada con la prestación de cuidados en todos los niveles de asistencia sanitaria en la Red de Atención a la Salud.

Bons encontros e Cidadania: os Sentidos Atribuídos ao Serviço de Convivência e Fortalecimento de Vínculos pelos(as) Idosos(as) / Good meetings and Citizenship: the meanings attributed to the Service of Coexistence and Strengthening of Bonds (Serviço de Convivência e Fortalecimento de Vínculos) by Older Adults / Buenos Encuentros y Ciudadanía: los Significados Atribuidos al Servicio de Convivencia y Fortalecimiento de Lazos por los Adultos Mayores

Resumo: Este artigo tem como objetivo analisar os dados produzidos por uma pesquisa qualitativa que investigou os sentidos atribuídos ao Serviço de Convivência e Fortalecimento de Vínculos (SCFV) por seus usuários(as) em Florianópolis/SC. Por meio da observação participante realizada em um SCFV durante três meses e da aplicação de uma entrevista coletiva com idosos(as), este artigo traz algumas análises sobre os processos de significação vivenciados por esses sujeitos. Apoiados na perspectiva sócio-histórica, elaboramos dois eixos de significação, que serão discutidos neste artigo: 1) Intersubjetividade e vínculo: o SCFV como "lugar acolhedor" e de "bons encontros"; 2) O(a) idoso(a) e os processos de exclusão: o SCFV como promotor da cidadania. Em termos de resultados, é possível afirmar que esse espaço se configura como um lugar importante na vida desses(as) idosos(as) - onde eles(as) se sentem acolhidos, ouvidos e reconhecidos como sujeitos. Além do fato de esse espaço ser marcado por afetos e "bons encontros", o grupo também o revelou como um lugar potente para processos de reflexão e questionamento contra as diversas formas de segregação e violências vividas cotidianamente por ele.

Abstract: This study aims to analyze the data produced by qualitative research that investigated the meanings attributed to the Service of Coexistence and Strengthening of Bonds (Serviço de Convivência e Fortalecimento de Vínculos - SCFV) by its users in the municipality of Florianópolis. By participant observation carried out in an SCFV for three months and the application of a collective interview with older adults, this study will bring some analysis of the processes of meaning experienced by these subjects. Sustained by the socio-historical perspective, we elaborated two axes of meaning to be discussed in this study : 1. Intersubjectivity and bonding: the SCFV as a "warm place" and "good meetings;" and 2. Older adults and processes of exclusion: the SCFV as a enhancer of citizenship. Results show that this space configures an important place in the lives of these older adults — a place in which they feel welcomed, heard, and recognized as subjects. In addition to the fact this space is marked by affections and "good meetings," the group also shows itself as a potent place for processes of reflection and questioning against the various forms of segregation and violence daily experienced by these people.

Resumen: Este artículo tiene como objetivo analizar los datos producidos por un estudio cualitativo sobre los significados atribuidos al Servicio de Convivencia y Fortalecimiento de Lazos (SCFL) por sus usuarios en Florianópolis (Santa Catarina, Brasil). Desde la observación participante realizada en un SCFL durante el período de tres meses y desde la aplicación de una entrevista colectiva con personas mayores, este artículo presenta algunos análisis sobre los procesos de significado vividos por estos sujetos. Apoyados en la perspectiva sociohistórica, elaboramos dos ejes de significado que serán discutidos: 1) Intersubjetividad y vinculación: el SCFL como "lugar de acogida" y "buenos encuentros"; 2) Las personas mayores y los procesos de exclusión: el SCFV como promotor de ciudadanía. Los resultados permiten afirmar que este espacio se configura como un lugar importante en la vida de estas personas mayores, un lugar donde se sienten acogidos, escuchados y reconocidos como sujetos. Además de que este espacio está marcado por afectos y "buenos encuentros", el grupo también se reveló como un lugar propenso a procesos de reflexión y cuestionamiento frente a las diversas formas de segregación y violencia que viven a diario estas personas.

Pessoa idosa, mercado de trabalho, idadismo e a saúde do trabalhador: revisão de escopo / Elderly people, labor market, ageism, and worker health: scope review

Resumo Objetivo Caracterizar o conhecimento que relacione a velhice, trabalho, idadismo e ações na saúde do trabalhador a partir de uma revisão de escopo. Método Baseado em uma pergunta norteadora e critérios de busca foi realizada uma seleção de artigos entre abril a junho de 2023 nas bases Scientific Eletrônico Library Online (SCIELO), Web of Science, Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e PUBMED. No total de 1.745 produções encontradas, 26 artigos corresponderam aos critérios de elegibilidade, sendo estes publicados nos últimos 10 anos. Resultados Da análise, resultaram duas categorias a serem discutidas: impactos do idadismo na saúde do trabalhador e ações para a saúde da pessoa idosa nos ambientes de trabalho. As principais medidas encontradas para a redução do idadismo nos ambientes de trabalho incluem a presença de uma equipe de saúde nos ambientes de trabalho que levam ao adoecimento e incentivo à educação em gerontologia para os trabalhadores. Conclusão Observou-se a incipiência de estudos sobre a velhice do trabalhador, o reconhecimento acerca das doenças mais frequentes entre pessoas idosas que trabalham e as profissões em que elas se encontram mais vulneráveis ao idadismo. Novas investigações poderão dar subsídios para que sejam promovidas políticas com atenção a pessoa idosa que trabalha e o desenvolvimento de uma cultura organizacional geracional.

Abstract Objective To characterize the knowledge that relates aging, work, ageism, and actions in worker health through a scope review. Method Based on a guiding question and search criteria, a selection of papers was conducted between April and June 2023 in the Scientific Electronic Library Online (SCIELO), Web of Science, Scopus, Latin American and Caribbean Health Sciences Literature (LILACS), and PUBMED databases. Out of a total of 1,745 productions found, 26 papers met the eligibility criteria, all of which were published in the last 10 years. Results From the analysis, two categories emerged for discussion: the impacts of ageism on worker health and actions for the health of elderly people in work environments. The main measures found to reduce ageism in work environments include the presence of a health team in workplaces that lead to illness and the promotion of education in gerontology for workers. Conclusion The incipiency of studies on the aging of the worker was observed, as well as the recognition of the most common diseases among elderly people who work and the professions in which they are most vulnerable to ageism. Further investigations may provide insights for the promotion of policies attentive to elderly people in the workforce and the development of a generational organizational culture.

Effect of mindfulness-based therapy on postoperative cognitive function and sleep quality in elderly patients after surgery under local anesthesia / 四川精神卫生

BackgroundPostoperative cognitive dysfunction （POCD） is a common complication in elderly patients after surgery， and has a great impact on postoperative rehabilitation of patients. ObjectiveTo explore the effect of mindfulness-based therapy on cognitive function and sleep quality in elderly patients after surgery under local anesthesia， so as to provide references for reducing their incidence risk of POCD and improving sleep quality. MethodsThe simple random sampling method was utilized to select 78 elderly patients who underwent surgery under local anesthesia in The Third Hospital of Mianyang from March 2022 to March 2023. Participants were assigned into study group and control group， each with 39 cases. All patients were subjected to conventional treatment and nursing interventions， and study group added mindfulness-based therapy on this basis. Mini-Mental State Examination （MMSE） was administered to patients on 1 day before surgery， and on the 1st， 3rd and 5th day after surgery. Pittsburgh Sleep Quality Index （PSQI） was employed on 1 day before surgery and on the 3rd day after surgery. ResultsMMSE scores revealed a significant time effect， group effect and time×group interaction effect （F=78.251， 197.071， 371.915， P<0.05）. Analysis of simple effect denoted that study group scored higher on MMSE on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （t=-3.579， -1.764， -0.253， P<0.05）. Study group reported lower incidence rates of POCD on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （χ2=2.631， 3.471， 5.135， P<0.05）. On the 3rd day after surgery，study group scored lower on PSQI than control group（P<0.05）， and PSQI total score， sleep latency， subjective sleep quality， daytime dysfunction and hypnotic drug use factor scores of study group were lower than baseline， with statistical significance（F=43.175， 12.594， 11.092， 4.579， 3.514， P<0.01）. ConclusionMindfulness-based therapy may have certain value in reducing incidence of POCD and improving sleep quality in elderly patients who underwent surgery under local anesthesia.

Prognostic Model of Traditional Chinese and Western Medicine in Middle-aged and Elderly Patients with Type 2 Diabetes Mellitus Complicated with Stable Angina Pectoris / 中国实验方剂学杂志

ObjectiveThis study aims to explore risk factors for the development of major adverse cardiovascular and cerebrovascular events （MACCEs） in middle-aged and elderly patients with type 2 diabetes mellitus complicated with stable angina pectoris （T2DM-SAP） based on real-world clinical data in traditional Chinese medicine （TCM）， so as to develop a COX proportional risk prediction model and visualize the predicted results using a nomogram. MethodBased on the clinical scientific research information sharing system， the medical records of 586 T2DM-SAP patients （45-94 years old） were collected from January 2012 to December 2019， including age， gender， course of disease， major medical history， laboratory examination， tongue image， pulse image， TCM syndrome， and major treatment drugs. MACCE outcome indicators of patients were obtained by telephone follow-up and re-hospitalization records. The data was divided into a training set and a validation set according to 7∶3. In the training set， COX univariate analysis was used to determine the risk factors for MACCE in T2DM-SAP patients， and then variables were screened by forward-backward stepwise regression method， so as to establish a MACCE risk prediction model and construct a nomogram. The predictive efficacy of the model was reflected by the C-index， receiver operating characteristic （ROC） curve， calibration map， and clinical decision curve. ResultThe history of cerebrovascular disease ［Hazard ratio （HR）=1.983， 95% confidence interval （CI，1.314-2.993）］， low-density lipoprotein （LDL-C/mmol·L-1）≥4.1［HR=2.683， 95%CI（1.461-4.925）］， dull red tongue ［HR=1.955， 95%CI（1.273-3.002）］， dull purple tongue ［HR=4.214， 95%CI（2.017-8.803）］， white thick coating ［HR=3.030， 95%CI（1.634-9.293）］， thin and weak pulse ［HR=2.233， 95%CI（1.283-3.888）］， and syndrome of wind-phlegm blocking collaterals ［HR=2.007， 95%CI（1.179-3.418）］ were found to be risk factors in middle-aged and elderly T2DM-SAP patients. Insulin ［HR=0.604， 95%CI（0.399-0.914）］， glycosidase inhibitor ［HR=0.627， 95%CI（0.409-0.962）］， and TCM treatment ［HR=0.328， 95%CI（0.214-0.503）］ were protective factors in middle-aged and elderly T2DM-SAP patients. The prediction model was constructed based on the above risk factors. The C-index of the model was 0.818 （95% CI 0.777 -0.859） in the training set and 0.814 （95% CI 0.773-0.855） in the validation set， and the change of C-index over time was plotted. The AUC of patients for 5， 10， 15 years in the training set was 0.71， 0.67， and 0.61. The AUC of patients for 5， 10， and 15 years in the validation set was 0.60， 0.68， and 0.63， respectively. The calibration map and clinical decision curves of 5， 10， 15 years were drawn in the training set and the validation set， respectively. The model was well calibrated and clinically effective. ConclusionThe history of cerebrovascular disease， LDL， dull red tongue， dull purple tongue， white thick coating， thin and weak pulse， and syndrome of wind-phlegm blocking collaterals are risk factors for MACCE in middle-aged and elderly T2DM-SAP patients， and insulin， glycosidase inhibitors， TCM treatment are protective factors for MACCE in middle-aged and elderly T2DM-SAP patients. A clinical prediction model is established accordingly. This model has good discrimination， calibration degree， and clinical effectiveness and provides a scientific basis for the prevention and treatment of MACCE in middle-aged and elderly T2DM-SAP patients.

Survey and analysis of long term care service needs for home disabled elderly people in Beiliu city / 现代医院

Objective To investigate the current situation of long-term care needs of the elderly with home-based disabil-ity in Beiliu City,and provide data support for the development of Internet plus care services in Beiliu City.Methods A ques-tionnaire survey method was used to design and distribute a survey questionnaire titled"Survey Questionnaire on Home Care Serv-ice Needs of Disabled Elderly People",to investigate the nursing service methods and home care needs of disabled elderly people in Beiliu City.Results Disabled elderly people mainly choose home-based nursing services,with a high demand for basic care,comfortable care,rehabilitation care,psychological care,and other aspects.Conclusion Home care is of great significance for improving the quality of life of disabled elderly people,and requires policy support such as medical insurance to promote the sup-ply of nursing services and meet the care needs of disabled elderly people.

Exploration of the construction of health science popularization system in medical institutions from the perspective of aging / 现代医院

With the intensification of global aging trends,the health needs of the elderly are becoming increasingly prom-inent.As one of the main forces in implementing the Healthy China strategy,medical and health institutions play a crucial role in building a scientific,systematic,and targeted health popularization system to improve the health status of the elderly and delay the aging process.However,medical institutions face numerous challenges in constructing a health popularization system for the elderly.Based on the perspective of aging,this article focuses on the hot and difficult issues encountered by the elderly when see-king medical treatment,pays attention to the blind spots and hot issues in elderly health,explores the importance and construction methods of health popularization systems for the elderly in medical and health institutions,in order to enhance the health aware-ness of the elderly,promote health behavior changes,and ultimately improve the health status and quality of life of the elderly.

Effect of ropivacaine combined with dexmedetomidine for ultrasound-guided erector spinae plane block in elderly thoracoscopic radical surgery for lung cancer / 新乡医学院学报

Objective To explore the efficacy of ropivacaine combined with dexmedetomidine for ultrasound-guided erector spinae plane block(ESPB)in elderly patients undergoing thoracoscopic radical surgery for lung cancer.Methods A total of 119 lung cancer patients who underwent thoracoscopic radical resection of pulmonary carcinoma at the First Affiliated Hospital of Henan Polytechnic University from October 2020 to October 2022 were selected and randomly divided into the observation group(n=59)and the control group(n=60),with 3 patients excluded from the observation group and 4 patients excluded from the control group.Finally,56 patients were included in each group.Patients in the control group received ultrasound-guided ESPB with ropivacaine,while patients in the observation group received ultrasound-guided ESPB with both ropivacaine and dexmedetomidine.The pre-anesthesia preparation,anesthesia induction,and anesthesia maintenance were the same for patients in both groups,and patients in both groups used patient-controlled intravenous analgesia to relieve pain after surgery.The heart rate(HR)and mean arterial pressure(MAP)of patients in the two groups after entry(T1),successful block(T2),skin incision(T3),and end of surgery(T4),as well as the visual analogue scale(VAS)scores at rest and activity 6,12,24,and 48 hours after surgery were recorded.The amount of analgesic medication used,the number of analgesia pump presses,and the incidence of delirium and adverse reactions were compared between the two groups 48 hours after surgery.Results The MAP and HR of patients in the two groups at T2 and T3 were significantly higher than those at T1 and T4(P＜0.05).However,there was no significant difference in MAP and HR between the two groups at T4 and T1(P＞0.05),and there was also no significant difference in MAP and HR between the two groups at T2 and T3(P＞0.05).The patients in both groups showed no significant difference in MAP and HR at T1(P＞0.05),while at T2,T3,and T4,the MAP and HR in the observation group were significantly lower than those in the control group(P＜0.05).The patients in both groups had lower VAS scores at rest and activity 12,24,and 48 hours postope-ratively compared to 6 hours postoperatively(P＜0.05).The patients in both groups had lower VAS scores at rest and activity 24 and 48 hours postoperatively compared to 12 hours postoperatively(P＜0.05).The patients in both groups had lower VAS scores in both resting and active states 48 hours after surgery compared to 24 hours after surgery(P＜0.05).There was no significant difference in VAS scores at both rest and activity 6 hours after surgery between the two groups(P＞0.05).At 12,24,and 48 hours after surgery,the patients in the observation group had lower VAS scores in both resting and active states compared to the control group(P＜0.05).Compared with the control group,the observation group used fewer analgesic drugs and pressed analgesia pumps less 48 hours after surgery(P＜0.05).The incidence of overall adverse reactions within 48 hours after surgery was 5.36％(3/56)and 8.93％(5/56),respectively;there was no significant difference in the incidence of overall adverse reactions between the two groups(x2=0.135,P＞0.05).The incidence of delirium within 48 hours after surgery in the control and observation groups was 14.29％(8/56)and 3.57％(2/56),respectively.The incidence of delirium in the observation group was significantly lower than that in the control group(x2=3.953,P＜0.05).Conclusion The use of ropivacaine combined with dexmedetomidine for ultrasound-guided ESPB in elderly patients undergoing thoracoscopic radical surgery for lung cancer can maintain perioperative hemodynamic sta-bility,improve analgesic effect,and reduce the dosage of analgesic drugs,the number of analgesia pump presses,and the inci-dence of postoperative delirium.

Retrospective analysis on the effect of prevention and treatment of senile pulmonary tuberculosis in Hubei Province / 公共卫生与预防医学

Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020, and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province． Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed. The registration rates and composition ratios were analyzed using χ2 test and χ2 test for trend. Results A total of 135 976 tuberculosis patients were reported in Hubei from 2016 to 2020. The annual average registration rate of elderly tuberculosis among the elderly registered residence population (referring to the registration rate of elderly registered residence population aged 60 and above as the denominator, and tuberculosis patients aged 60 and above as the numerator) was 263.51/100 000. The highest rate was 300.02/100,000 in 2017, and the lowest was 188.19/100,000 in 2020 (χ2=70,227.603, P2trend=40.448，P2trend=740.911, P2trend=380.557, P2trend=323.764, P<0.001). Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend. It is necessary to focus on the efforts of designated hospitals to proactively identify cases, increase the proportion of confirmed cases, maintain a high tracking in place, reduce medical delays, and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.

Prevalence of central obesity among the elderly with different body mass indexes in Xuhui District， Shanghai / 上海预防医学

ObjectiveTo investigate the prevalence and influencing factors of overweight， obesity and central obesity among elderly residents in Xuhui District， and to analyze the epidemiological status of central obesity in elderly people with different body mass indexes. MethodsThe third round of health status and health service utilization monitoring data in Xuhui District was used. The information collected from questionnaire survey and physical examination were analyzed. SPSS 20.0 software was used for χ2 test， trend χ2 test and multinominal logistic regression analysis. Results5 096 survey subjects were included. The prevalence of overweight， general obesity， and central obesity in the residents aged 60 and above in Xuhui District were 34.3%， 6.5%， and 29.2%， respectively. There was gender difference in the rates of overweight， obesity， and central obesity among the residents. The overweight and central obesity rates in males were higher than those in females， while the obesity rate was lower than that in females （P<0.05）. Multinominal logistic regression analysis showed that in comparison with the normal weight non-central obesity group drinking only at party （OR=1.729， 95%CI： 1.184‒2.525）， and hypertension （OR=1.637， 95%CI： 1.305‒2.053）， were highly associated with normal weight with central obesity. Aged 60‒ years （OR=1.589， 95%CI： 1.190‒2.120）， aged 70‒ years （OR=1.763， 95%CI： 1.327‒2.342）， male （OR=1.379， 95%CI： 1.134‒1.676）， hypertension （OR=2.231， 95%CI： 1.878‒2.649）， former smokers （OR=1.437， 95%CI： 1.027‒2.011）， drinking at party only （OR=1.491， 95%CI： 1.107‒2.006）， and drinking ≥3 times per week （OR=1.611， 95%CI： 1.116‒2.325）， were highly associated with overweight combined with central obesity. Aged 60‒ years （OR=3.817， 95%CI： 2.251‒6.474）， aged 70‒ years （OR=3.084， 95%CI： 1.838‒5.175）， hypertension （OR=3.683， 95%CI： 2.753‒4.929）， diabetes （OR=2.085， 95%CI： 1.511‒2.878）， former smokers （OR=1.835， 95%CI： 1.043‒3.226）， were highly associated with compound obesity. Central obesity was found in the elderly residents with different BMI categories， and the rate of central obesity increased with the increase of BMI grade. ConclusionThe prevalence of overweight， obesity and central obesity among the elderly aged 60 years and above in Xuhui District is not optimistic. Attention should be paid to the elderly under 80 years old who are with hypertension and/or diabetes， alcohol consumption， low educational level and not doing physical exercise. Especially for the central obesity population with normal BMI， measures should be taken to prevent and intervene the occurrence of obesity and related diseases.

Mediating effects of cognitive function on the relationship between literacy level and depressive symptoms in middle-aged and elderly people in China / 公共卫生与预防医学

Objective　To explore the mediating role of cognitive function in the association between literacy level and depressive symptoms in middle-aged and elderly people in China. Methods　 Using the fourth national follow-up data of the China Health and Elderly Care Tracking Survey 2018, 8 124 middle-aged and elderly people aged 45 years and above were included as the study subjects. The PROCESS 4.0 program was used to test the mediating effect of cognitive function between literacy level and depressive symptoms, and the Bootstrap method was used for the mediator variable validation. Results The detection rate of depressive symptoms among middle-aged and elderly people in China was 38.10%. After controlling for gender, place of residence, marital status, smoking, alcohol consumption, and exercise, literacy level was a negative predictor of depressive symptoms in middle-aged and elderly people (β =－0.480, t =－11.248, P<0.001). Cognitive function accounted for 58.75% of the amount of mediating effect between literacy level and depressive symptoms. Conclusion 　Literacy level and cognitive function are associated with depressive symptoms in middle-aged and elderly people. Literacy level can influence depressive symptoms directly or indirectly through the mediation of cognitive dysfunction.

Probability and related factors of pulmonary fibrosis in 350 elderly patients / 公共卫生与预防医学

Objective To explore the probability and associated factors of pulmonary fibrosis in 350 cases of elderly pneumonia. Methods Elderly patients who received diagnosis and treatment at Changzhi Medical College Affiliated Peace Hospital from January 2018 to December 2022 were selected, and 350 patients who met the criteria were included in the study. Analyze its clinical data, incidence of pulmonary fibrosis, and analyze the relationship between the two. Results The average age of 350 patients was (63.51 ± 5.74) years old; 219 cases were common type , 72 cases were severe type, and 59 cases were critically ill. At admission, the CT signs were: ground glass in 66 cases (18.86%) , paving stone in 37 cases (10.57%), consolidation in 73 cases (20.86%), nodules in 93 cases (26.57%) , fried egg sign in 20 cases (5.71%) , and mosaic sign in 61 cases (17.43%). At discharge, the lesion signs were as follows: 61 cases (17.43%) had no lesions, 207 cases (59.14%) maintained the original lesion signs, and 82 cases (23.43%) evolved into other signs. 76 cases of pulmonary fibrosis were discharged, with an incidence rate of 21.71%. There were significant differences in the incidence of pulmonary fibrosis among patients with different ages, lesion evolution during treatment, lesion signs at discharge, and clinical stages (all P<0.001). Pulmonary fibrosis is positively correlated with age (P=0.047), lesion signs at discharge (P=0.032), and clinical classification (P=0.010). The incidence of lesions presenting as paving stones (P=0.014) and fibrosis in critically ill patients (P=0.013) at discharge is higher. Age increase (P=0.047) , wide range of lesions at admission (P=0.042), evolution of lesions into other signs at discharge (P=0.016), and clinical classification as severe (P=0.008) or critically ill (P=0.021) are independent risk factors for the development of pulmonary fibrosis in elderly pneumonia patients. Conclusion The incidence of pulmonary fibrosis in elderly patients exceeds 20%. Increasing age, wide range of lesions upon admission, evolution of lesions into other signs upon discharge, and clinical classification as severe or critically ill are independent risk factors for the occurrence of pulmonary fibrosis in elderly pneumonia patients.

Summary of best evidences for oral health management in community elderly people / 重庆医学

Objective To retrieve,evaluate and summarize the relevant evidences of oral health manage-ment in the community elderly people to provide reference for community medical staffs.Methods The evi-dences on oral health management of the comunity elderly people were systematically retrieved from various guide websites and Chinese and English databases.The retrieval limit was from the database establishment to September 2021.The research group conducted the evaluation and extracted the evidences according to the rel-evant literature evaluation criteria.Results A total of 17 literatures were included,including 5 guidelines,4 expert consensuses and 8 systematic reviews.A total of 28 pieces of evidences were summarized from the five aspects of assessment and examination,daily life management,management of special oral problems,denture management,and education and training.Conclusion Community medical staffs should fully consider the clin-ical situation,department resources and patient wishes,and conduct the evidence application to increase the o-ral health level of the community elderly people.

Lesão por pressão na pessoa idosa: curso massivo aberto online para enfermeiro à luz da teoria de Margaret Newman / Pressure injuries in the elderly: massive open online course for nurses in light of Margaret Newman's theory

Resumo: Pesquisa de desenvolvimento metodológico cujo objetivo foi desenvolver curso massivo aberto on-line (MOOC) para enfermeiros sobre prevenção e tratamento da lesão por pressão na pessoa idosa, à luz da Teoria de Margaret Newman. Trata-se de pesquisa metodológica, aplicada à elaboração e validação de curso on-line, pautada nas cinco etapas do modelo ADDIE de design instrucional. A primeira etapa envolveu análise, com a definição de conteúdo a partir de revisão integrativa de literatura: utilização das Teorias de enfermagem no cuidado às pessoas idosas com lesão por pressão. A segunda etapa proporcionou desenho do curso, com definição de objetivos de aprendizagem, atividades, duração e ferramentas do curso. A etapa três foi representada pela criação e edição dos recursos educacionais abertos. Na etapa quatro, ocorreu a hospedagem do conteúdo e mídias no ambiente virtual escolhido. A quinta etapa incluiu a validação de conteúdo e aparência por juízes experts. Como resultados, emergiram três produções científicas em formato de revisão integrativa: 1) estratégias de continuidade do cuidado de enfermagem, ações preventivas e de tratamento da lesão por pressão em pessoas idosas; 2) Avaliação e fatores de risco para desenvolvimento de lesão por pressão em pessoas idosas; 3) Prevenção e tratamento de lesões por pressão em pessoas idosas. Foram criados 24 produtos técnicos em formato de material didático, contemplados por: quatro (4) vídeos de apresentação: apresentação das autoras, apresentação do curso, apresentação dos módulos 1 e 2; seis (6) videoaulas, três (3) para o módulo 1 e três (3) para o módulo 2. Oito (8) infográficos divididos entre módulo 1 e módulo 2; dois (2) ebooks módulo 1 e módulo 2; um (1) estudo de caso; um (1) podcast e um (1) Curso no modelo MOOC ­ Lesão por pressão na pessoa idosa: cuidado de enfermagem à luz da Teoria de Margaret Newman. O curso MOOC desenvolvido é potente para fortalecer a assistência de enfermagem aos idosos portadores de lesão por pressão. Além disso trata-se de estratégia de ensino inovadora para estudantes da área de ciências da saúde. A aplicação de forma sistematizada do referencial teórico deste estudo, a Teoria da expansão da consciência de Margaret Newman, evidenciou-se no processo formativo, uma vez que a teorista discute a enfermagem como profissão e que o processo formativo é estabelecido pela identidade e responde por suas práticas. Ressalta-se a relevância do estudo por se tratar do desenvolvimento de um curso teórico, no modelo MOOC, gratuito, disponível em uma plataforma confiável e aberta, em que o cursista pode organizar-se para o cumprimento das atividades conforme a sua disponibilidade de carga horária.

Abstract: Methodological development research whose objective was to develop a massive open online course (MOOC) for nurses on the prevention and treatment of pressure injuries in the elderly, in light of Margaret Newman's Theory. This is methodological research, applied to the development and validation of an online course, based on the five stages of the ADDIE model of instructional design. The first stage involved analysis, with the definition of content based on an integrative literature review: use of nursing theories in the care of elderly people with pressure injuries. The second stage provided the course design, defining learning objectives, activities, duration and course tools. Step three was represented by the creation and editing of open educational resources. In step four, the content and media were hosted in the chosen virtual environment. The fifth stage included content and appearance validation by expert judges. As results, three scientific productions emerged in the format of an integrative review: 1) nursing care continuity strategies, preventive actions and treatment of pressure injuries in elderly people; 2) Assessment and risk factors for the development of pressure injuries in elderly people; 3) Prevention and treatment of pressure injuries in elderly people. 24 technical products were created in teaching material format, comprising: four (4) presentation videos: presentation of the authors, presentation of the course, presentation of modules 1 and 2; six (6) video lessons, three (3) for module 1 and three (3) for module 2. Eight (8) infographics divided between module 1 and module 2; two (2) e-books module 1 and module 2; one (1) case study; one (1) podcast and one (1) Course using the MOOC model ­ Pressure injuries in the elderly: nursing care in light of Margaret Newman's Theory. The MOOC course developed is powerful in strengthening nursing care for elderly people with pressure injuries. Furthermore, it is an innovative teaching strategy for students in the area of health sciences. The systematic application of the theoretical framework of this study, Margaret Newman's Consciousness Expansion Theory, was evident in the training process, since the theorist discusses nursing as a profession and that the training process is established by identity and responds to their practices. The relevance of the study is highlighted as it concerns the development of a theoretical course, in the MOOC model, free of charge, available on a reliable and open platform, in which the course participant can organize themselves to carry out the activities according to their availability. hourly.

Sistema de Cribado Primario para la Sarcopenia en Personas Adultas Mayores Basado en Inteligencia Artificial / Primary Screening System for Sarcopenia in Elderly People Based on Artificial Intelligence

Resumen Este estudio propone un sistema de cribado primario para diagnosticar la sarcopenia en adultos mayores a través de medidas antropométricas. Esta investigación exploratoria involucró inicialmente a 150 personas de edad avanzada, de las cuales 122 fueron seleccionadas después de un proceso de depuración de datos. Empleando técnicas de aprendizaje automático como el agrupamiento jerárquico y los árboles de decisión, se redujeron las 13 medidas antropométricas originales a cinco características clave. Se crearon tres sistemas de clasificación: el primero basado en parámetros previamente establecidos (masa muscular apendicular, velocidad de marcha y fuerza de agarre); el segundo consideró medidas de las extremidades superiores (masa muscular promedio de ambos brazos, fuerza de agarre, velocidad de marcha y porcentaje de grasa corporal); y el tercero se centró en las medidas de las extremidades inferiores (masa muscular promedio de ambas piernas, fuerza de agarre, velocidad de marcha y porcentaje de grasa corporal). Estos sistemas de clasificación se validaron clínicamente en un grupo de 57 pacientes previamente diagnosticados por especialistas, de los cuales 10 recibieron un diagnóstico positivo de sarcopenia. Los resultados mostraron eficiencias similares en los tres sistemas, con ocho de los diez diagnósticos positivos conocidos clasificados en el mismo grupo. Además, el estudio proporciona puntos de corte específicos para cada sistema, facilitando así el diagnóstico clínico de la sarcopenia por parte de profesionales médicos.

Abstract This study proposes a primary screening system for diagnosing sarcopenia in older adults through anthropometric measures. This exploratory research initially involved 150 elderly individuals, of whom 122 were selected after a data purification process. Using machine learning techniques such as hierarchical clustering and decision trees, the original set of 13 anthropometric measures was reduced to five key features. Three classification systems were created: the first based on previously established parameters (appendicular muscle mass, walking speed, and grip strength); the second considered upper limb measures (average muscle mass of both arms, grip strength, walking speed, and body fat percentage); and the third focused on lower limb measures (average muscle mass of both legs, grip strength, walking speed, and body fat percentage). These classification systems were clinically validated in a group of 57 patients previously diagnosed by specialists, of which 10 received a positive sarcopenia diagnosis. The results showed similar efficiencies in all three systems, with eight of the ten known positive diagnoses classified in the same group. Additionally, the study provides specific cut-off points for each system, thus facilitating the clinical diagnosis of sarcopenia by medical professionals.

Factors Affecting Lifelong Learning Participation in Older Adults: Relationship with Subjective Well-being, Physical Activity/Exercise, and Social Activities / 社会薬学

The significance of lifelong learning is increasing in Japan’s aging society. The purpose of this study is to clarify the factors that affect the participation in lifelong learning of the elderly people in relation to subjective well-being, physical activity/exercise, and social activity. We conducted a questionnaire survey among lifelong learning participants. The contents of the questionnaire items were scored and the influence of the number of years of participation in the lifetime learning was examined using confirmatory factor analysis. There were 207 participants with an average age of 73.2 years old. In terms of health and life, most of the participants answered positively. In terms of coping with stress, many respondents had that coping strategy. Their nutritional intake and exercise habits were good. They had a high rate of health check-ups, were highly interested in disease prevention and paid attention to their health management. From the exploratory factor analysis of the questionnaire results, the five common factors behind lifelong learning participants were “subjective well-being,” “physical activity/exercise,” “subjective view of health,” “nutrition/diet,” and “social activity.” There was a negative relationship between “years of participation in lifelong learning” and “subjective well-being,” and a positive relationship between “physical activity/exercise” and “social activity” of these latent variables. In conclusion, many of the lifelong learning participants were highly conscious of their health, had acquired appropriate habits in terms of exercise and nutrition, and had a high subjective well-being. The elderly’s continuous participation in lifelong learning is beneficial for “physical activity/exercise” and “social activity.”

Immunological CD4+ T-cell recovery and prognostic influencing factors in elderly HIV/AIDS patients of different genders after antiviral therapy / 中国热带医学

@#Objective　To investigate the prognostic influencing factors and recovery of CD4+ T lymphocytes in elderly HIV/AIDS patients after antiviral therapy by analyzing basic data and clinical follow-up data of elderly HIV/AIDS patients. Methods　The clinical data of 3 618 elderly AIDS patients aged ≥50 yeas who received antiretroviral therapy (ART) at HIV ART sites in Liuzhou City from 2005-2015 were collected. The data, including basic information, CD4+ T cell count, WHO clinical stage, infection route and follow-up, were retrospectively analyzed. Kaplan-Meier method was used to compare the differences in patient survival, multivariate Cox regression to analyze the independent influencing factors influencing the risk of death, and to compare the recovery of CD4+ T cell counts during follow-up of patients of different genders. Results　During the follow-up period, the 5-year cumulative survival rate up to the observation endpoint was 0.82 (female) and 0.66 (male). Multivariate logistic regression analysis showed that the risk factors affecting the effect of antiviral treatment were age (OR=1.909, 95%CI:1.474-2.464, P<0.001), body mass index (BMI) (OR=0.744, 95%CI: 0.574-0.965, P=0.026), opportunistic infections (OI) (OR=1.223, 95%CI:1.028-1.454, P=0.023), gender (OR=0.692, 95%CI:0.503-0.952, P=0.023) and baseline CD4+ T lymphocytes count (OR=0.563, 95%CI:0.429-0.739, P<0.001). Recovery of CD4+ T lymphocyte counts showed when baseline CD4+ T lymphocyte counts were less than 200 cells/mm3, older women with HIV/AIDS had higher CD4+ T lymphocytes than men at all times of ART treatment (P<0.05). Conclusions　Older women have a higher survival rate than older men after five years of antiviral therapy. Age, BMI, gender, OI and baseline CD4+T lymphocyte count may be important indicators that affect the survival of elderly HIV/AIDS patients. Older women showed better recovery of CD4+ T lymphocytes than older men during the 4-year follow-up period after ART.

Analysis of rare genotypes of thalassemia in Laibin area of Guangxi / 公共卫生与预防医学

Objective To investigate the rare genotypes and mutation frequency of thalassemia in Laibin area of Guangxi , to intervene the birth of children with moderate or severe thalassemia, and to better guide the genetic diagnosis and prenatal diagnosis. Methods A total of 282 patients of hematological phenotypes inconsistent with genotypes in Laibin City (four counties, one city and one district) were tested for rare genotypes. Results A total of 50 cases were found to carry rare thalassemia gene mutations, including 23 cases of β-globin gene mutation containing 9 types of mutations, and 27 cases of α-globin gene mutation containing 7 types of mutations. There were 4 homotypic thalassemia couples with one party carrying rare thalassemia gene mutation. After prenatal diagnosis, one case was found to be a rare mutation carrier , two cases to be a double heterozygote, and one case to be a common mutation carrier. Conclusion The data of thalassemia genotype spectrum in Laibin , Guangxi. It is suggested that when the hematological phenotype is not consistent with the genotype , it should be detected by other molecular techniques to avoid the birth of children with moderate or severe thalassemia, which is also helpful for clinical diagnosis and treatment guidance, population screening and genetic counseling.

Association between depressive symptoms and risk of coronary heart disease in middle-aged and elderly Chinese community: An empirical analysis based on CHARLS database / 西安交通大学学报(医学版)

【Objective】 To investigate the association of depressive symptoms with the predicted risk of coronary heart disease in middle-aged and elderly Chinese based on a large community study. 【Methods】 A total of 2532 cases in the group without depression and 2758 cases in the group with depression were included. We compared the two groups in general demographics, information related to coronary heart disease risk, and physical function and ability to perform daily living. We also analyzed the factors associated with coronary heart disease risk by linear regression. 【Results】 ① Demographic information: The group with depression had a higher mean age, a higher proportion of women, more people with poor marital status, and a higher number of comorbid chronic diseases compared with the group without depression (all P<0.05). ② Risk indicators related to coronary heart disease: The group with depression had more people with diabetes and a significantly higher systolic blood pressure compared with the group without depression (P<0.05). The two groups did not significantly differ in the proportion of smokers, diastolic blood pressure, LDL-C, or HDL-C (all P>0.05). The risk of coronary heart disease was significantly higher in the group with depression than in the group without depression (P<0.05). ③ Physical function and ability of daily living: The physical function score, physical self-care score, and instrumental daily living ability were significantly higher in the group with depression than in the group without depression (all P<0.001). ④ Linear regression showed that except for gender, age, marital status, comorbid diabetes, smoking, systolic and diastolic blood pressure, HDL-C and LDL-C were associated with risk of coronary heart disease (P<0.05); CESD was the only factor associated with the risk of coronary heart disease [B=0.019, 95% CI: (0.015, 0.032), P=0.032]. 【Conclusion】 The risk of coronary heart disease is higher in middle-aged and elderly people with depressive symptoms than in those without depressive symptoms. Having depressive symptoms is one of the risk factors for coronary heart disease in middle-aged and elderly people.