Social determinants of health and their relation to suboptimal health status in the context of 3PM: a latent profile analysis.

Background: Suboptimal health is identified as a reversible phase occurring before chronic diseases manifest, emphasizing the significance of early detection and intervention in predictive, preventive, and personalized medicine (PPPM/3PM). While the biological and genetic factors associated with suboptimal health have received considerable attention, the influence of social determinants of health (SDH) remains relatively understudied. By comprehensively understanding the SDH influencing suboptimal health, healthcare providers can tailor interventions to address individual needs, improving health outcomes and facilitating the transition to optimal well-being. This study aimed to identify distinct profiles within SDH indicators and examine their association with suboptimal health status. Method: This cross-sectional study was conducted from June 16 to September 23, 2023, in five regions of China. Various SDH indicators, such as family health, economic status, eHealth literacy, mental disorder, social support, health behavior, and sleep quality, were examined in this study. Latent profile analysis was employed to identify distinct profiles based on these SDH indicators. Logistic regression analysis by profile was used to investigate the association between these profiles and suboptimal health status. Results: The analysis included 4918 individuals. Latent profile analysis revealed three distinct profiles (prevalence): the Adversely Burdened Vulnerability Group (37.6%), the Adversity-Driven Struggle Group (11.7%), and the Advantaged Resilience Group (50.7%). These profiles exhibited significant differences in suboptimal health status (p < 0.001). The Adversely Burdened Vulnerability Group had the highest risk of suboptimal health, followed by the Adversity-Driven Struggle Group, while the Advantaged Resilience Group had the lowest risk. Conclusions and relevance: Distinct profiles based on SDH indicators are associated with suboptimal health status. Healthcare providers should integrate SDH assessment into routine clinical practice to customize interventions and address specific needs. This study reveals that the group with the highest risk of suboptimal health stands out as the youngest among all the groups, underscoring the critical importance of early intervention and targeted prevention strategies within the framework of 3PM. Tailored interventions for the Adversely Burdened Vulnerability Group should focus on economic opportunities, healthcare access, healthy food options, and social support. Leveraging their higher eHealth literacy and resourcefulness, interventions empower the Adversity-Driven Struggle Group. By addressing healthcare utilization, substance use, and social support, targeted interventions effectively reduce suboptimal health risks and improve well-being in vulnerable populations. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00365-5.

The effect of family health on suboptimal health status: The parallel mediation role of sleep quality and health behaviour.

Background: The prevalence of suboptimal health status has been increasing worldwide, posing a significant challenge to public health. Meanwhile, family health has been recognised as an important factor influencing individual health outcomes. However, the mechanisms through which family health affects suboptimal health status remain unclear. We aimed to investigate the parallel mediation role of sleep quality and health behaviour in the relationship between family health and suboptimal health status. Methods: We conducted a cross-sectional online survey with a sample of adults >18 years old from four provinces in China. The survey questionnaires queried their demographic characteristics, family health, suboptimal health status, sleep quality, and health behaviour. We assessed family health by the Family Health Scale-Short Form and suboptimal health status using the Suboptimal Health Status Questionnaire. We employed structural equation modelling to analyse the data and test the proposed mediation model. Results: we collected 4918 valid questionnaires. The mean age of the participants was 30.1 years (standard deviation = 12.5). The correlation analysis demonstrated a significant negative association between family health and suboptimal health status (r = -0.44; P < 0.001). The results of the parallel mediation analysis showed that family health had a significant indirect effect on suboptimal health status through both sleep quality (ß = -0.350; P < 0.001) and health behaviour (ß = -0.137; P < 0.001). The total indirect effect of family health on suboptimal health status through both sleep quality and health behaviour was also significant (ß = -0.569, P < 0.001). Conclusions: This study highlights the significance of family health as a predictor of suboptimal health status and suggests that sleep quality and health behaviour are parallel mediators in this relationship. By understanding the role of family health, sleep quality, and health behaviour, interventions can be targeted to improve overall health outcomes.

[Characteristics of Heavy Metals and Other Elements in Atmospheric Dry and Wet Deposition and Health Risk Assessment of a Typical Industrial and Mining City in Central Yunnan].

In order to study the characteristics of atmospheric dry and wet deposition elements and the health risks of typical industrial and mining cities in central Yunnan, the atmospheric dry and wet depositions collected from June 2019 to July 2020 in Anning city were selected as the research object and measured. The contents of the 11 indexes TN, F, Cr, Ni, Cu, Zn, Cd, Pb, P, As, and Hg were determined, the annual atmospheric deposition flux was calculated, and the exposure risk model was used to assess the risk to human health. The results showed that:1 In addition to Cr, Ni, and As in the atmospheric dry sediments, the average contents of the elements F, Cu, Zn, Cd, Pb, and Hg were significantly higher than those of the surface soil in Anning City, which were 5.82, 3.00, 28.27, 57.53, 2.83, and 1.08 times higher, respectively. The average contents of F and total nitrogen in wet deposition exceeded the standard value of surface water V-class water. 2 The annual atmospheric deposition flux of total nitrogen was the highest, and the annual deposition flux of eight heavy metal elements from smallest to largest was Hg

Patient safety and bedrail use as a global phenomenon: A prevalence study.

Background: Although bedrail use may increase the risk of accidents among patients, bedrails are still extensively used in healthcare facilities. Therefore, the field calls for a review of bedrail use in practice. Objective: This report examined the prevalence and implications of bedrail use in rehabilitation facilities in Hong Kong. The findings are compared with the current state of bedrail use worldwide. Design and methods: This work is a cross-sectional, observational study. A secondary analysis was conducted on the database of a prospective trial. Bilateral bedrail use was observed in two Hong Kong rehabilitation hospitals. Logistic regression was performed to examine the factors associated with bedrail use. Results: A total of 3,384 restraint observations were made. The bedrail rate was 31.34%, which revealed that bedrail use was the second most commonly used physical restraint. The fall history (OR: 2.84), cognitive impairment (OR: 0.91) and functional dependency (OR: 0.79) of patients were significant predictors of bedrail use, p < .05. Conclusion: This study examines bedrail prevalence through direct observation, which is the preferred method for examining bedrail use in practice. We found that actual bedrail use is higher than the numbers reported in previous studies in Hong Kong. In addition, our research reveals that bedrails are commonly used for vulnerable patients. This finding highlights the need to change nurses' beliefs on bedrail use through education. The management of these health facilities should also aim to create an institutional environment that promotes the reduction of bedrail use. Implementation strategies on restraint reduction should also fit the culture of the organisation and local nursing practices, as well as the staff's values. Impact Statement: This study provides preliminary information about the widespread use of bedrails in Hong Kong and other countries. The research also introduces effective ways to achieve the reduction of bedrail use.

Postgraduate nursing internationality education: A study in establishing an English nursing course.

Aim: The study was to explore the significant influence of an English nursing course in nursing postgraduate internationalization education. Design: A cross-sectional study. Method: The research object included three grades (a total of 18) of nursing postgraduate students in the Nursing School of Yangzhou University. A standardized four-section questionnaire designed by the authors was applied to the survey. Results: 88.89% were satisfied with the course design and application of the English nursing course, and the scores for all 6 items were above the average, but only 44.4% of the postgraduate students understood the course completely. In teaching design and content aspect, 88.9%-94.4% postgraduate nurses felt that the course learning requirements were clear and could improve their knowledge and capacity for scientific research. All of the postgraduate nurses were identified with the teacher's moral and academic characters. Conclusions: To establish English nursing courses for nursing postgraduate students is beneficial for postgraduate internationalization education.

Effectiveness of Education Courses in Enhancing Clinical Educators' Teaching Ability.

BACKGROUND: In China, the nursing discipline has undergone rapid development in recent years, and clinical educators are an important part of the nursing education team. In order to improve their teaching ability and become competent clinical educators, we provided learning opportunities to them. METHOD: To assess the effectiveness of education courses and modules, a cross-sectional study based on questionnaire responses was conducted. Sixty-six part-time clinical nurse educators from six teaching hospitals were included. A standardized four-section questionnaire developed by the authors was used. RESULTS: The education curriculum was approved by clinical educators (94%). The specific content in the education courses significantly improved the teaching ability (84%). From a teaching perspective, the confidence was enhanced; the clinical educators were able to control the purpose of teaching and learning objectives via a syllabus (92%). CONCLUSION: Education courses can improve teaching ability, reinforce teaching control, and promote the quality of clinical teaching. [J Contin Educ Nurs. 2019;50(8):367-373.].

Social Support, Health Literacy, and Health Care Utilization Among Older Adults.

The purpose of this study was to explore the relationship between social support, health literacy, and health care utilization in older Chinese adults. A cross-sectional survey design was employed. Data were collected from 32 nursing homes from Urumqi in Xinjiang of China. A total of 1486 respondents completed a pack of questionnaires. The average health literacy level of older adults in nursing homes was relatively low, only 73.68 ± 29.42 points; the average social support level was also relatively low, only 31.42 ± 7.12 points (lower than domestic norm of Chinese residents, P < .001). Both values were below the midpoint for the overall population, indicating a sample with below-average levels of healthy literacy and social support. Low social support levels are associated with poor health literacy and greater likelihood of hospital admission (P < .05). Social support was significantly associated with health literacy. Improving the quantity and quality of social support may be an effective means to obtain better health literacy and lower hospital admissions.

Health Literacy, Physical and Mental Health, and Activities of Daily Living Among Older Chinese Adults in Nursing Homes.

It is very important to estimate the prevalence of inadequate health literacy and determine whether or not health literacy level differences predict the physical and mental health status of older adults. A cluster sampling method was selected. A total of 1396 older adults were interviewed. Three instruments were included: the Chinese Citizen Health Literacy Questionnaire, Short Form 36, and Activity of Daily Living (ADL) Scale. The health literacy scores were very low (71.74 ± 28.35). The physical and mental health scores were all moderate. The ADLs was ⩾22, which suggests that the ADLs of older adults were poor. The major influencing factors of physical health include health literacy, ADL, alcohol consumption, household income, marital status, and former occupation. The major factors influencing mental health included ADL, former occupation, age, and smoking. Health literacy was associated with physical health, but was not associated with mental health. Improving health literacy could increase health management and health status of older adults.

Inflammation markers are associated with frailty in elderly patients with coronary heart disease.

The neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) are important indicators of adverse outcomes and have predictive value for many diseases; however, the relationships between frailty, and the NLR and RDW in patients with coronary heart disease (CHD) have not been determined. In this cross-sectional study, we investigated the association between frailty, and the NLR and RDW in elderly CHD patients ≥ 60 years of age. Frailty was defined according to frailty phenotype. Of 345 patients enrolled in the study, 22.6%, 58.3%, and 19.1% were characterized as robust, pre-frail, and frail, respectively. A significant positive correlation was observed between frailty and the NLR (r = 0.169) and RDW (r = 0.196). After adjusting for confounders, linear regression analyses showed that participants in the 4th quartile of the NLR or RDW were more likely to have a higher frailty phenotype score. Based on multivariable logistic regression, patients in the 4th quartile of the NLR and RDW, the fully-adjusted odds ratios for incident frailty were 2.894 (p = 0.011) and 2.494 (p = 0.040), respectively. Our findings indicate that frailty is associated with the NLR and RDW in elderly patients with CHD.

Effectiveness of the teach-back method for improving the health literacy of senior citizens in nursing homes.

AIM: To explore the effectiveness of the teach-back method for improving the health literacy of older adults in nursing homes in Ürümqi, the capital of Xinjiang, China. METHODS: Among the 27 registered nursing homes, 10 were selected randomly by size and divided into the intervention and control groups. A total of 127 older adults in the intervention group and 136 in the control group met the inclusion criteria. The intervention and control groups were educated by using the teach-back and traditional methods, respectively, in this 6 month study. The Chinese Citizen Health Literacy Questionnaire was used to evaluate the effects of the interventions. RESULTS: Pre-intervention, the health literacy level of the cohorts was relatively low. Postintervention, the total health literacy score of the intervention group increased, while the total health literacy score of the control group had increased to a lesser extent. The total and four-dimension scores of the two groups were statistically significant. The intergroup difference in the two groups, and the intervention group's total health literacy score and each dimension score were higher than in the control group; these differences were statistically significant . CONCLUSIONS: The teach-back method can improve the health literacy level of older adults through short-term educational intervention. The teach-back method should be adopted by more healthcare providers and applied to improve the health literacy education of older adults.

Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese.

BACKGROUND: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. METHODS: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. RESULTS: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001). The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001). The elderly with higher health literacy scores were significantly less likely to have risky behaviors (smoking, regular drinking, and lack of physical exercise), and in turn significantly more likely to undergo health examinations regularly, report good self-rated health, and significantly more likely to access sufficient health information from multiple sources (p < 0.001). No differences were noted between the health literacy score and BMI (p > 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p < 0.001). CONCLUSIONS: Health literacy was significantly associated with health-related behaviors in elderly Chinese. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health-related behaviors. To reduce risky habits, educational interventions to improve health literacy should be simultaneously conducted in health promotion work.

Pure Single-Crystalline Na1.1V3O7.9 Nanobelts as Superior Cathode Materials for Rechargeable Sodium-Ion Batteries.

Pure single-crystalline Na1.1V3O7.9 nanobelts are successfully synthesized for the first time via a facile yet effective strategy. When used as cathode materials for Na-ion batteries, the novel nanobelts exhibit excellent electrochemical performance. Given the ease and effectiveness of the synthesis route as well as the very promising electrochemical performance, the results obtained may be extended to other next-generation cathode materials for Na-ion batteries.

[Leaching behavior of Pb, Cd and Zn from soil stabilized by lime stabilized sludge].

Stabilization of Pb, Cd and Zn spiked soil by using lime-stabilized sewage sludge( LSS) as amendment was investigated in this study, and the effectiveness was evaluated by using leaching tests ( TCLP, SPLP and de-ionized water) and modified BCR sequential extraction procedure. The results of TCLP indicated that the concentrations of heavy metals in TCLP leachate reduced significantly with the increase of the mass percentage of the LSS and the leaching reduction rates were as high as 99. 54% for Zn, 99. 60% for Pb, 99. 85% for Cd at 40% of LSS addition. When evaluated by SPLP and de-ionized water leaching method, the concentrations of Zn and Pb in leachate decreased obviously at 10% and 20% of LSS additions, but subsequently increased at 30% and 40% because of redissolution of Zn and Pb at strong base condition. After pH value of LLS-stabilized soil was adjusted by ferrous sulfate and phosphoric acid for recovering soil plantation function, the pH value of the soil decreased effectively, in the meantime promoting the stabilization effectiveness of Pb and Zn. The BCR test revealed that compared with the spiked soil exchangeable proportion of Zn, Pb, Cd in the soil and the soils adjusted by ferrous sulfate obviously declined, which implied the migration for Pb, Cd and Zn of contaminated soil could be confined. This study results show that municipal LSS can be reused in the stabilization of heavy metal contaminated soils and physical and chemical properties of LLS-stabilized soil are improved for plantation.

Nanoporous gold supported cobalt oxide microelectrodes as high-performance electrochemical biosensors.

Tremendous demands for electrochemical biosensors with high sensitivity and reliability, fast response and excellent selectivity have stimulated intensive research on developing versatile materials with ultrahigh electrocatalytic activity. Here we report flexible and self-supported microelectrodes with a seamless solid/nanoporous gold/cobalt oxide hybrid structure for electrochemical nonenzymatic glucose biosensors. As a result of synergistic electrocatalytic activity of the gold skeleton and cobalt oxide nanoparticles towards glucose oxidation, amperometric glucose biosensors based on the hybrid microelectrodes exhibit multi-linear detection ranges with ultrahigh sensitivities at a low potential of 0.26 V (versus Ag/AgCl). The sensitivity up to 12.5 mA mM⁻¹ cm⁻² with a short response time of less than 1 s gives rise to ultralow detection limit of 5 nM. The outstanding performance originates from a novel nanoarchitecture in which the cobalt oxide nanoparticles are incorporated into pore channels of the seamless solid/nanoporous Au microwires, providing excellent electronic/ionic conductivity and mass transport for the enhanced electrocatalysis.