The relationship between self-assessment living standard and mental health among the older in rural China: the mediating role of sleep quality.

BACKGROUND AND OBJECTIVE: Mental health imbalance are the main cause of anxiety, depression and happiness reduction in the older. Self-assessment living standard and sleep quality are both influencing factors of mental health. Meantime, self-assessment living standard has an impact on sleep quality. But there's no research on the relationship between the three, we conducted this study to explore the relationship between self-assessment living standard and mental health and the mediating role of sleep quality among the older in rural areas of China. METHODS: Using typical field sampling method, M County, Anhui Province was selected as the investigation site, and a total of 1223 respondents were selected. With the help of questionnaires enclosing respondents' sociodemographics information, 12 Items General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Scale (PSQI), face-to-face interviews were used to collect data. Bootstrap test was used for data analysis. RESULTS: The results showed that the age of the respondents ranged from 60 to 99 years, with an average age of (66.53 ± 6.77) years, the proportion of the older with a tendency to mental health problems was 24.7%. Most of the older people's self-assessment living standard was normal (average score was 2.89 ± 0.726), accounting for 59.3% of the total. The average sleep quality score was (6.97 ± 4.066), and 2.5% of the respondents reported serious sleep problems. older with low self- assessment living standards were more likely to report a higher propensity for psychological problems (ß = 0.420, P < 0.001) and poorer sleep quality (ß = 0.608, P < 0.001) than older with high self- assessment living standards. Mental health of the older may be related to sleep quality (ß = 0.117, P < 0.001). In addition, the effect of self- assessment living standard on mental health was significantly mediated by sleep quality (ß = 0.071, P < 0.001). CONCLUSION: Mental health is associated with self-assessment living standard, with this association mediated by sleep quality. A reasonable mechanism needs to be established to improve self-assessment living standard and sleep quality.

Correlation between functional disability and quality of life among rural elderly in Anhui province, China: a cross-sectional study.

OBJECTIVE: We aimed to explore the correlation between functional disability and quality of life (QoL). And exploring the interaction of functional disability, basic demographic characteristics and health-related information on QoL among the rural elderly in Anhui Province. METHODS: This study used multi-stage stratified cluster sampling in rural Anhui Province from January to July 2018 to conduct a cross-sectional survey of older adults who met the inclusion criteria. The Five-Dimensional European Quality Of Health Scale (EQ-5D) and the WHO Disability Assessment Schedule (WHODAS2.0) scale were used to evaluate the QoL and functional disability, and the basic demographic characteristics of the survey subjects were also collected. Using binary logistic and Classification and regression tree model (CART) models to analyze the data, explore the relationship between functional disability and QoL in the elderly. RESULTS: A total of 3491 older adults were included in the survey, and 3336 completed the entire survey, with an effective response rate of 95.56%. After adjusting for covariables, those who had limited in dimension of mobility (AOR=2.243, 95%CI: 1.743-2.885), getting along (AOR=1.615, 95%CI: 1.173-2.226), life activities (AOR=2.494, 95%CI:1.928-3.226), and social participation (AOR=2.218, 95%CI: 1.656-2.971) had a lower QoL. However, the dimension of cognition (AOR=0.477, 95%CI: 0.372-0.613) is a protective factor for QoL. Additionally, we also observe that 96.3% of those who were unemployed and limited in both mobility and life activities dimensions had a lower QoL, but among those who were robust in both mobility and social participation dimensions and not suffer from chronic diseases, 56.3% had a higher QoL. CONCLUSIONS: Our findings indicate that special attention should be paid to the elderly who are unemployed, have limited in cognition, getting along, social participation, mobility, life activities and cognition robust to improve their QoL. This research is of great significance for formulating targeted strategies and measures to improve the QoL for rural elderly.

Gender specific cut-off points of age for disability among rural elderly in Anhui Province, China.

Objective: The purpose of this study was to determine the optimal cut-off values of age for disability in order to predict the risk of disability for older adults in rural areas. Methods: WHO Disability Assessment Schedule 2.0 was used to assess disability. The cut-off values of age for disability were obtained by ROC curve analysis. Results: The cut-off points of age for cognition restriction, mobility restriction, self-care restriction, getting along with people restriction, life activities restriction, and social participation restriction for men were 70.5, 68.5, 72.5, 70.5, 71.5, and 68.5 years old, respectively. The cut-off points of age for cognition disability, mobility restriction, self-care disability, getting along with people disability, life activities disability, and social participation disability for women were 72.5, 71.5, 70.5, 70.5, 71.5, and 71.5 years old, respectively. Over the cut-off values of age was an independent risk factor for disability (P < 0.05). Conclusion: Presenting first disability symptoms were different between men and women. Preventive efforts to prevent future disability should be different for men and women.

[Analysis of the outcomes of squamous cell carcinoma of maxillary sinus with 3 different comprehensive treatments].

PURPOSE: To study the medium or long-term survival rates of different methods used in the treatment of advanced squamous cell carcinoma of the maxillary sinus (SCMS). METHODS: Patients were treated by one of the following methods: 231 patients were treated with induction chemotherapy, followed by radical resection and radiotherapy (CSR); 128 patients were treated with preoperative irradiation (RS), and 87 patients underwent adjuvant radiotherapy (RSR). A total of 446 cases of SCMS from June 1985 to December 2008 were managed with unscheduled application of the above 3 kinds of treatment options. The dose of 231 patients with CSR and 128 patients with RS was 60-70 Gy/30-35 times/5-7 week and 40-50 gy/20-25 times/4-5 week, respectively. Dose in RSR accounted for half of that in CSR. The number of cases undergoing total resection of maxilla, subtotal resection of maxilla and extended excision of maxilla were 299, 111 and 36, respectively (13 cases had orbital exenteration). The number of patients with therapeutic radical neck dissection, functional neck dissection and supraomohyoid neck dissection were 49, 73 and 56, respectively. The data was analyzed with SPSS16.0 software package. RESULTS: Five-year survival rate in 446 cases was 45.96% (205/446), and 220 patients died of tumors, among which 84.09% (185/220) of death were due to local recurrences. The 5-year survival rate of CSR, RS, and RSR were 45.88% (106/23), 46.09% (59/128) and 45.97% (40/87), respectively; Totally 83.33% of CSR, 85.71% of RS and 83.72% of RSR died of local recurrences. There was no significant difference in the survival rates among CSR, RS and RSR. CONCLUSIONS: Unscheduled comprehensive treatment have a higher 5-year survival rate in this advanced SCMS. Elective neck irradiation and neck dissection are necessary for medium or advanced squamous cell carcinoma of maxillary sinus.

[Grade IV myelosuppression after induction chemotherapy of TPF on oral cancer: clinical analysis of 29 cases].

PURPOSE: To observe and evaluate the clinical features and treatment strategies of IV myelosuppression after induction chemotherapy of oral mucosa squamous cell carcinoma under conventional dosage. METHODS: Twenty-nine patients of oral mucosa squamous cell carcinoma pathologically diagnosed between 2006 and 2012 were enrolled into this study. The patients received induction chemotherapy with docetaxel-cisplatin-5-fluorouracil (TPF) and suffered from grade IV myelosuppression. Regulations and treatment strategies of the bone marrow myelosuppression were analyzed, retrospectively. RESULTS: Twenty-nine cases had bone marrow suppression 9-14 days after induction chemotherapy, and the median time was 10 days, with a "U"-shaped fluctuation pattern. There were 26 cases with colony-stimulating factor(CSF) therapy completing treatment according to the schedule and 2 cases were required to radiotherapy because of unsatisfied effect of CSF therapy. One case died and the death rate after chemotherapy was 0.68% in this group. CONCLUSIONS: The incidence of grade IV myelosuppression is normal and fatal. This study shows the starting time of the "U"-shaped fluctuation and the necessaries of adding CSF therapy at the same time. The emergency treatment of myelosuppression should be used including single disinfected ward mouthwash and therapy of CSF drug.