A Quantitative Meta-Analysis and Qualitative Meta-Synthesis of Aged Care Residents' Experiences of Autonomy, Being Controlled, and Optimal Functioning.

BACKGROUND AND OBJECTIVES: The poor mental health of adults living in aged care needs addressing. Improvements to nutrition and exercise are important, but mental health requires a psychological approach. Self-determination theory finds that autonomy is essential to wellbeing while experiences of being controlled undermine it. A review of existing quantitative data could underscore the importance of autonomy in aged care, and a review of the qualitative literature could inform ways to promote autonomy and avoid control. Testing these possibilities was the objective of this research. RESEARCH DESIGN AND METHODS: We conducted a mixed-methods systematic review of studies investigating autonomy, control, and indices of optimal functioning in aged care settings. The search identified 30 eligible reports (19 quantitative, 11 qualitative), including 141 quantitative effect sizes, 84 qualitative data items, and N = 2,668. Quantitative effects were pooled using three-level meta-analytic structural equation models, and the qualitative data were meta-synthesized using a grounded theory approach. RESULTS: As predicted, the meta-analysis showed a positive effect of aged care residents' autonomy and their wellness, r = 0.33 [95% CI: 0.27, 0.39], and a negative effect of control, r = -0.16 [95% CI: -0.27, -0.06]. The meta-synthesis revealed seven primary and three sub-themes describing the nuanced ways autonomy, control, and help seeking are manifest in residential aged care settings. DISCUSSION AND IMPLICATIONS: The results suggest that autonomy should be supported, and unnecessary external control should be minimized in residential aged care, and we discuss ways the sector could strive for both aims.

[Study on the relationship between secondhand smoke exposure and dyslipidemia in adult residents in Beijing].

Objective: To understand the relationship between secondhand smoke exposure and dyslipidemia among adults in Beijing and to provide a scientific basis for relevant intervention. Methods: Data were from Beijing Adult Non-communicable and Chronic Diseases and Risk Factors Surveillance Program in 2017. A total of 13 240 respondents were selected by multistage cluster stratified sampling method. The monitoring contents include a questionnaire survey, physical measurement, collection of fasting venous blood, and determination of related biochemical indicators. SPSS 20.0 software was used for the chi-square test and multivariate logistic regression analysis. Results: The prevalence of total dyslipidemia (39.27%), hypertriglyceridemia (22.61%), and high LDL-C (6.03%) were the highest among those exposed to daily secondhand smoke. Among the male respondents, the prevalence of total dyslipidemia (44.42%) and hypertriglyceridemia (26.12%) were the highest among those exposed to secondhand smoke daily. Multivariate logistic regression analysis after adjustment for confounding factors showed that compared with no exposure to secondhand smoke, the population with an average exposure frequency of 1-3 days per week had the highest risk of total dyslipidemia (OR=1.276, 95%CI: 1.023-1.591). Among the patients with hypertriglyceridemia, those exposed to secondhand smoke daily had the highest risk (OR=1.356, 95%CI: 1.107-1.661). Among the male respondents, those exposed to secondhand smoke for 1-3 days per week had a higher risk of total dyslipidemia (OR=1.366, 95%CI: 1.019-1.831), and the highest risk of hypertriglyceridemia (OR=1.377, 95%CI: 1.058-1.793). There was no significant correlation between the frequency of secondhand smoke exposure and the risk of dyslipidemia among female respondents. Conclusions: Secondhand smoke exposure in Beijing adults, especially men, will increase the risk of total dyslipidemia, especially hyperlipidemia. Improving personal health awareness and minimizing or avoiding exposure to secondhand smoke is necessary.

[Study on the relationship between indexes of different abnormal weight and dyslipidemia in adults in Beijing City].

Objective: To analyze the relationship and consistency between indexes of different abnormal weight and dyslipidemia in adults in Beijing City. Methods: From August to December of 2017, 4 975 residents aged 18 to 79 years old in 5 districts of Beijing were randomly selected as subjects by using a multi-stage stratified cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The prevalence of overweight/obesity, high body fat rate, central obesity, and high waist-to-height ratio was calculated. Partial correlation was used to analyze the correlation of blood lipid with body mass index (BMI), body fat rate, waist circumference and waist-height ratio. Logistic regression analysis for complex sampling was used to analyze the relationship between indexes of different abnormal weight and dyslipidemia after controlling for relevant risk factors, including age, sex, smoking status, drinking, insufficiency intake of vegetable and fruit, physical inactivity. Kappa value was computed to analyze the consistency between indexes of different abnormal weight. Results: The weighted prevalence of dyslipidemia was 30.48%, and it was higher in men than that in women (40.16% vs. 20.52%, P<0.01). The weighted rate of overweight/obesity, high body fat rate, central obesity, and high waist-to-height ratio was 56.65%, 47.52%, 42.48% and 59.45%, respectively. BMI, body fat rate, waist circumference and waist-to-height ratio were positively correlated with the level of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol, and negatively correlated with high-density lipoprotein cholesterol. Logistic regression analysis for complex sampling showed that the high body fat rate (OR=1.67, 95%CI: 1.35-2.07), overweight/obesity (OR=1.65, 95%CI: 1.26-2.14) and high waist-to-height ratio (OR=1.46, 95%CI: 1.09-1.96) were associated with dyslipidemias. Kappa values of high body fat rate with overweight/obesity, high waist-to-height ratio and central obesity were 0.65, 0.53 and 0.58, respectively (P<0.05). Conclusion: In 2017, the prevalence of dyslipidemia in adults in Beijing City is high, especially in men. Overweight/obesity, high body fat rate and high waist-to-height ratio are associated with dyslipidemia. The high body fat rate is most associated with dyslipidemia.

[Investigation on knowledge, attitude and behavior of salt reduction in adults of Beijing in 2017].

Objective: To explore the knowledge, attitude and behavior of salt reduction in adults of Beijing in 2017. Methods: Based on the monitoring data of chronic diseases and corresponding risk factors in adults of Beijing in 2017, the indicators of salt reduction knowledge, attitude and behavior of 13 240 participants aged 18-79 years old were analyzed. The awareness rate, attitude support rate and behavior rate were calculated by complex weighting method, and compared among different age groups, genders, residential areas, and history of hypertension. The proportion of people taking various salt reduction measures to the total number of people was compared. Results: The awareness rate of recommended daily salt intake, the awareness of hypertension caused or aggravated by more salt intake, the attitude support rate and behavior rate of adults were 31.77%, 88.56%, 90.27% and 53.86%, respectively. After weighted adjustment, the awareness rate of recommended daily salt intake was 31.08%, which increased with age (χ2trend=431.56, P<0.001) and education level (χ2trend=95.44, P<0.001). The awareness rate of women was higher than that of men (χ²=118.89, P<0.001), and the awareness rate of population in urban areas was higher than that of population in suburban areas (χ²=34.09, P=0.001). The awareness rate of hypertension caused or aggravated by eating more salt was 86.73%. The support rate of salt reduction attitude was 90.45%. The rate of salt-reducing behavior was 54.05%. Among different salt reduction measures, reducing salt when cooking was the most common measure (52.41%), while the least common one (35.22%) was using low sodium salt. Logistic regression model analysis showed that the gender, age, education level, self-reported history of hypertension, awareness of salt recommendation, awareness of hypertension caused or aggravated by eating more salt, and salt reduction attitude were significantly associated with salt reduction behavior. Conclusion: In 2017, adults in Beijing have a basic understanding of the impact of high-salt diet on health and support salt reduction, but the rate of salt reduction behavior is still relatively low. There are obvious gender and age differences, and the salt reduction measure is simple. Targeted measures should be taken to promote the formation of salt reduction behavior.

[Current status of regular exercise and influencing factors in 18-64 year old labor force population in Beijing].

Objective: To understand the regular exercise status and influencing factors in 18-64 year-old labor force population in Beijing, and provide evidences for behavioral intervention. Methods: Data were collected from Beijing Adult Non-communicable and Chronic Diseases and Risk Factors Surveillance Program from August to December, 2017. The stratified cluster sampling method was used to select 13 240 survey subjects throughout the city. The valid sample size included in this study were 11 604 persons aged 18 to 64 years. Questionnaire was used to collection the information about basic demographic characteristics, chronic disease history and physical activity prevalence of the study subjects. The body height and weight were measured by standard methods. Fasting venous blood samples were collected for the detection of fasting blood glucose, blood lipids and other biochemical indicators. Software SPSS 20.0 was used fort complex sampling sample weighting and data analysis. Results: The proportions of the study subjects who did regular exercise and never had leisure-time activity in 18-64 year-old labor force population in Beijing were 23.74% (95%CI: 21.51%-26.12%) and 64.34% (95%CI: 61.66%-66.94%) respectively; The average daily physical activity time was 23.44 min (95%CI: 21.16-25.71), and the total daily sedentary behavior time was 6.96 hours (95%CI: 6.80-7.13). With the increase of age, the proportions of the study subjects who did regular exercise and never had leisure-time activity increased (P=0.006, P<0.001). With the increase of educational level, the proportion of those who did regular exercise increased (P<0.001), and the proportion of those who never had leisure-time activity decreased (P<0.001); the higher the level of physical activity, the higher the regular exercise proportion (P<0.001); the proportions of employed people who did regular exercise was lower than those in unemployed people (P<0.001); the proportions of women never had leisure-time activity was higher than those in men (P=0.024). The results of multivariate analysis showed that older age and higher education level were positive factors for regular exercise (35- years old: OR=0.653, 95%CI: 0.530-0.804, P<0.001; 50-64 years old: OR=0.695, 95%CI: 0.560-0.864, P=0.001; high school/technical secondary school/technical School: OR=0.679, 95%CI: 0.593-0.777, P<0.001; college graduation: OR=0.478, 95%CI: 0.387-0.590, P<0.001; bachelor degree and above: OR=0.435, 95%CI: 0.347-0.546, P<0.001), while employment (OR=1.631, 95%CI: 1.330-2.000, P<0.001) and married/cohabitation (OR=1.340, 95%CI: 1.093-1.644, P=0.038) were negative factors for regular exercise. Conclusions: The rate of regular exercise in 18-64 year-old labor force population in Beijing needs to be improved. Older age and high educational level were positive factors for regular exercise, while being married and employed were negative factors for it.

[Analysis of the current status and related factors of oral nutritional supplements intake among 18-79 years old in Beijing in 2017].

Objective: To understand the current status of taking nutrient supplements for residents aged 18 to 79 years old in Beijing and its related factors. Methods: Data were gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used, and participants aged 18-79 were sampled from 16 districts. The questionnaire included chronic diseases and related risk factors, health knowledge, and oral nutritional supplements within 12 months. Multivariate logistic regression models were established to analyze associated factors that affect the intake of nutrient supplements. Results: The weighted prevalence of supplements use was 13.1% among 12 696 subjects within the past 12 months. The proportions of multivitamins (4.7%), B vitamins (4.5%), and folic acid (3.2%) were higher. The prevalence of supplement use of young people (18-39 years old) and the elderly (60-79 years old) was higher than middle-aged people (40-59 years old) (χ2=54.09, P<0.001). Except for the age group of 70-79 years old, the consumption rate of women was significantly higher than that of men (P<0.05). After adjusting age and sex, among patients with hypertension, diabetes, or dyslipidemia, the control rates of blood pressure, glucose and lipids of patients who take nutrient supplements were higher than those who do not (P<0.05). And participants who took nutrient supplements had a more heightened awareness rate of health knowledge, such as the hazards of smoking and second-hand smoke, and recommended amount of salt per day (P<0.001). The multi-factor logistic analysis found that nutrient supplement-related factors include women, old age, higher education level, living in urban, insufficient physical activity, sleeping problems, active physical examination, blood pressure control among patients, and health knowledge (P<0.05). Conclusions: The factors of nutrient supplements use were related to sex, age, education level, health status, and health literacy. We should pay attention to key populations and guide them to establish the correct concept of taking nutrient supplements.

[The current status and trend of disease burden of neoplasms in 1990 and 2016 for Beijing people].

Objective: To investigate the current status and trend of disease burden of neoplasms in 1990 and 2016 for Beijing people. Methods: The incidence situation, deaths status and disease burden of neoplasms in Beijing were described by using the results of the global burden of diseases study 2016 (GBD 2016). The measurement index included incidence, death, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted years (DALY). Using the average world population from 2000 to 2025 as standard population to calculate the age-standardized incidence rate, mortality rate, DALY rate, YLL rate and YLD rate. Results: The age-standardized incidence rate of neoplasms in 2016 was 250.68 per 100 000, which increased by 30.03% than in 1990. The age-standardized mortality rate was 115.83 per 100 000, which decreased by 26.71% than in 1990. The DALY, YLL and YLD of neoplasms in 2016 were 671.2, 651.1 and 20.1 thousand person-years, respectively, which increased by 85.83%, 82.79% and 302.00% than those in 1990. The age-standardized DALY rate and YLL rate were 2 549.00 and 2 469.84 per 100 000, which decreased by 33.22% and 34.30% than those in 1990. The age-standardized YLD rate was 79.16 per 100 000, which increased by 37.17% than that in 1990. The male DALY, YLL and YLD in 2016 were 428.8, 417.8 and 11.0 thousand person-years, and female were 242.4, 233.3 and 9.1 thousand person-years, respectively.Among different neoplasms, the top three neoplasms of DALY and YLL were lung cancer, liver cancer, colon and rectum cancer, the top three of YLD were lung cancer, colon and rectum cancer, breast cancer. The topped group of disease burden of neoplasms was aged from 50 to 69 years old, the DALY of which was 323.6 thousand person-years, accounted for 48.21% of all DALY, and increased by 87.70% than that in 1990. Conclusions: The disease burden of neoplasms in Beijing is dominated by YLL, and the YLD increases rapidly. The burden is severe in the group of aged from 50 to 69 years old, and the male is severer than female. Lung cancer ranks the first of the disease burden of neoplasms. The DALY of colorectal cancer has increased. Comprehensive strategies should be promoted, including cultivating a good lifestyle and implementing prevention and control of neoplasm risk factors as early as teenage group, early screening of high-risk population, and enhancing the instruction of patients' treatment and rehabilitation.

[Comprehensive control rate and related factros of diabetes mellitus in Beijing].

Objective: To investigate the comprehensive control situation and related factors of diabetes mellitus. Methods: From August to December of 2017, 13 259 residents aged 18 to 79 years old were randomly selected as the subjects by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The effective sample size was 13 240. A total of 1 592 diabetes patients were found. In this study, 917 diabetes patients who had been diagnosed before the investigation were selected as subjects. The comprehensive control of diabetes patients was analyzed. The situation of diabetes patients with hypertension, dyslipidemia, overweight and obesity, coronary heart diseases was analyzed. Logistic regression analysis of complex sampling was used to analyze the related factors of diabetes comprehensive control. Results: The average age of 917 patients with diabetes was (58.5±0.7) years old. The proportion of people who participated in diabetes follow-up management was 29.0%. There were 89.5% diabetes patients with one or more chronic diseases. The comprehensive control rate of diabetes mellitus was 2.0%, men and women were 1.8% and 2.3%, respectively (P>0.05). The rate of comprehensive control among those diabetes patients with chronic diseases was 0.4%, lower than that of those without chronic diseases (15.6%, P<0.05). The comprehensive control rate of people who participated in diabetes follow-up management was 1.4%. The control rate of blood glucose, blood pressure, blood lipid and weight of diabetes mellitus was 30.9%, 30.2%, 17.4% and 27.7%, respectively. Logistic regression analysis of complex sampling showed that excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus, OR value was 31.41, 39.98 and 0.29, P<0.05. Conclusion: The comprehensive control rate of diabetes mellitus was low. Excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus.

[Study on the relationship between sleep-related problems and dyslipidemia among adults in Beijing].

Objective: To investigate the status quo of sleelated problems and relationship with dyslipidemia among adults in Beijing. Methods: From August to December 2017, 13 188 residents aged 18-79 years old were randomly selected as the subjects of this study, by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory testing were used in this study. The questionnaire included demographic characteristics and status quo of sleep. Height and weight were measured, with fasting venous blood collected to test the levels of TC, HDL-C, LDL-C and TG. Results: In Beijing, 52.1% of the adults involved in this study were having sleep-related problems which appeared higher in patients with dyslipidemia (55.1%) than those without (50.7%). Rates of sleep-related problems as snoring, difficult to get into sleep, waking at night, waking early and taking sleeping pills were 30.1%, 18.8%, 24.6%, 20.1% and 3.0%, respectively. The prevalence rates of high TC, high TG and high LDL-C were 7.5%, 23.5% and 6.6%, respectively among subjects with snoring and as, 5.7%, 15.5% and 4.9%, respectively among those without. The average level of TC of people easy to wake at night was 4.74 mmol/L, higher than that of those without (4.66 mmol/L). The prevalence of high TC among those waking at night was 7.5%, higher than that of those without (5.8%). After controlling potential confounding factors as age, sex, smoking, overweight and obesity, snoring was significantly positively correlated to the levels of TC, TG and LDL-C (P<0.05) and presenting as risk factor for dyslipidemia, with OR=1.248 (P<0.05). Conclusion: Sleep-related problems appeared serious, with snoring and waking at night the main ones among adults in Beijing. Snoring was significantly positively correlated with the levels of TC, TG and LDL-C and served an independent risk factor for dyslipidemia.

[Association between sleep and serum hemoglobin A1c in nondiabetic population in Beijing].

Objective: To understand the status quo of sleep and its associations with serum hemoglobin A1c (HbA1c) among nondiabetic people of 18-79 years old in Beijing. Methods: Data was gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified clusters sampling method was used while the 18-79 years old were sampled from the 16 districts of Beijing. Questionnaires would include information on demographic characteristics, chronic diseases and related risk factors, sleep duration and related problems (snore/asphyxia, difficult to get to sleep, waking often during the night, waking up early or taking sleeping pills) within the last 30 days. Complex sampling logistic regression models were established to analyze the association between sleep-related problems and serum HbA1c. Results: A total of 11 608 non-diabetic participants were involved in this study, with average age, reported sleep duration and median of serum HbA1c level as (43.36±15.27) years old, (7.49±1.29) h/d and 5.30%, respectively. 47.38% of them reported having sleep problems within the last 30 days. With the increasing time of sleep, serum HbA1c level was fluctuating significantly (F=413.06, P<0.01). Significant differences appeared in serum HbA1c levels among different age groups (t=358.3, P<0.01). Among participants with several kinds of sleep problems, the serum HbA1c levels were significantly higher than those without, through the single factor analysis (U=15.11, P<0.01). After adjusting for potential confounding factors, the combination of one sleep-related problem (OR=1.21, 95%CI: 1.03-1.41) and snore/asphyxia were associated with higher serum HbA1c levels (HbA1c≥5.7%) (OR=1.37, 95%CI: 1.16-1.61). People under 60 years of age were with higher risk of having higher serum HbA1c levels. Conclusion: Duration and sleep-related problems might affect the serum HbA1c levels, especially among those younger than 60 years of age.

[Study on intention of smoking concession, awareness of smoking hazards and impact on smoking status in residents aged 18-65 years in Beijing].

Objective: To understand the awareness of smoking hazards and intention of smoking concession in residents aged 18-65 years in Beijing, and provide scientific evidence for the development and improvement of tobacco control policies and measures. Methods: Data were collected from the 2017 Beijing Non-communicable and Chronic Disease surveillance. A multi-stage stratified cluster sampling method was used to take samples from 165 communities in 16 districts of Beijing. Logistic regression was used to analyze the influencing factors. Results: Among 11 594 participants, 49.93% had no intention of smoking concession. The percentage of refusing smoking concession was higher in men (50.39%) than in women (43.01%), the difference was significant ( χ(2)=14.211, P=0.002), and higher in suburban residents (56.78%) than in urban residents (45.30%), the difference was significant ( χ(2)=51.977, P<0.001). For the smoking cessation motivation, "illness" was the reason for more former smokers (29.88%) compared with current smokers (11.50%), the difference was significant ( χ(2)=85.865, P<0.001). The awareness rates of smoking hazards was higher in women (34.97%) than in men (32.63%), the difference was significant (Z=5.612, P<0.001), higher in suburban residents (35.44%) than in urban residents (33.03%), the difference was significant (Z=-3.734, P<0.001), and higher in never smokers (35.15%) than in smokers (30.06%), the difference was significant ( χ(2)=62.277, P=0.005). Multiple logistic regression analysis results showed people with general awareness (OR=0.61, 95%CI: 0.39-0.94) and poor awareness (OR=0.67, 95%CI: 0.50-0.90) of smoking hazards were less likely to quit smoking and people with general awareness (OR=0.64, 95%CI: 0.53-0.76) and poor awareness (OR=0.87, 95%CI: 0.78-0.98) of smoking hazards were more likely to smoke. Conclusions: Smokers aged 18-65 in Beijing had low willingness for smoking cessation. Health problem was main consideration for smoking cessation. Never-smokers had better awareness of smoking hazards than smokers, and the awareness of smoking hazards was an influencing factor of smoking status.

[Current status and changes of disease burden of cardio-cerebrovascular diseases in 1990 and 2016 for Beijing people].

Objective: To investigate the current status and changes of disease burden of cardio-cerebrovascular diseases in 1990 and 2016 for Beijing people. Methods: Using the results of the Global Burden of Diseases Study 2016 (GBD 2016) to describe deaths status and disease burden of cardio-cerebrovascular diseases in Beijing. The measurement index included the total deaths, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted years (DALY). Using the average world population from 2000 to 2025 as standard population to calculate the age-standardized mortality rate, DALY rate, YLL rate and YLD rate. Results: The age-standardized mortality rate of cardio-cerebrovascular diseases was 209.24 per 100 000. In 2016, DALY, YLL and YLD of cardio-cerebrovascular was 875.6, 733.6 and 142.0 thousand person-years, respectively, which has increased by 58.05%, 44.24% and 213.47%, respectively, than that in 1990. The age-standardized DALY rate and age-standardized YLL rate of cardio-cerebrovascular diseases in 2016 was 3 552.24 and 2 988.01 per 100 000 which has decreased by 47.90% and 52.43%, respectively, than that in 1990. The age-standardized YLD rate of cardio-cerebrovascular diseases in 2016 was 564.23 per 100 000 which increased by 5.10% than that in 1990. In 2016, the total death of cerebrovascular disease and ischemic heart disease was 17.6 thousand and 23.7 thousand, respectively. DALY was 396.3 and 393.6 thousand person-years in 2016, while 330.2 and 162.7 thousand person-years in 1990, which has increased by 20.02% and 141.92%, respectively. Conclusions: The disease burden of cardio-cerebrovascular disease is serious, especially the burden of cerebrovascular disease and ischemic heart disease. The disability burden of cerebrovascular disease is serious. The disease burden of ischemic heart disease has multiplied.

[Study on the current status of smoking, intention of tobacco concession and related risk factors among 18-65-year olds patients with chronic diseases in Beijing].

Objective: To understand the status, attitude and related risk factors on smoking among 18-65 years old patients with hypertension, diabetes, dyslipidemia, chronic obstructive pulmonary disease (COPD) or asthma in Beijing. Methods: Data was gathered from the 2014 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used and 19 815 participants aged 18-65 were sampled from 16 districts in Beijing. Results: Among all the 18 405 participants, male hypertensive patients showed a higher rate on current smoking than the other groups (χ(2)=17.695, P<0.001). Male patients with dyslipidemia had higher current smoking rate than the other groups (χ(2)=39.292, P<0.001). However, female patients with COPD or with asthma showed higher rate on current smoking than the other groups (χ(2)=6.276, P=0.012), (χ(2)=8.245, P=0.004). Among the smokers, hypertensive patients presented lower rate (χ(2)=20.487, P<0.001) on intention of smoking concession, than the other groups. Patients with COPD showed greater intention in quitting smoking (χ(2)=6.085, P=0.048), than the other groups. Male patients with diabetes (χ(2)=9.219, P=0.010) or dyslipidemia (χ(2)=13.513, P=0.001) who had stopped smoking tobacco appeared having higher rates in keeping the current status. Results from logistic regression analyses showed that smoking was the risk factor for hypertension (OR=1.17), dyslipidemia (OR=1.25), COPD (OR=1.78), and asthma (OR=1.57). Conclusions: Patients with certain kinds of chronic diseases showed higher rate of current smoking and lower rate of quitting. Cigarette consumption appeared an important risk factor for patients with hypertension, dyslipidemia, COPD, or asthma in Beijing.

[Prevalence of hypercholesterolemia and influence factors in residents aged 18-65 years in Beijing].

Objective: To understand the prevalence of hypercholesterolemia and related risk factors in residents aged 18-65 years in Beijing and provide scientific evidence for the prevention and control of hypercholesterolemia. Methods: The data were collected from Beijing Non-communicable and Chronic Disease Survey and stratified cluster sampling method was used to select study subjects, and questionnaire investigation, physical measurement and laboratory examination were conducted to collect information. Results: The prevalence of hypercholesterolemia and borderline hypercholesterolemia was 6.26% and 21.34% respectively in 17 662 residents surveyed, the average total cholesterol level was (4.69±0.95) mmol/L. The prevalence of hypercholesterolemia was 6.33% in men and 6.20% in women, the difference was not significant (Z=1.64, P=0.10). The prevalence was higher inurban area than in suburb (6.73% vs. 5.59%; Z=-7.27, P<0.01). The prevalence of hypercholesterolemia increased with age (trend χ(2)=308.85, P<0.01). The trend was observed in men (trend χ(2)=81.65, P<0.01), in women (trend χ(2)=318.04, P<0.01), in urban area (trend χ(2)=201.77, P<0.01) and in suburb (trend χ(2)=114.65, P<0.01). Multiple logistic regression showed age, being female (OR=1.23, 95%CI: 1.04-1.45), overweight (OR=1.56, 95%CI: 1.34-1.81), obesity (OR=1.82, 95%CI: 1.54-2.16), smoking (OR=1.24, 95%CI: 1.03-1.50), alcohol use (OR=1.40, 95%CI: 1.12-1.75), beef and mutton intake >1 time per week (OR=1.19, 95%CI: 1.02-1.39) were risk factors. Conclusion: The prevalence of hypercholesterolemia in Beijing was lower than national level, and age, gender, location, BMI, smoking, alcohol use, beef and mutton intake were main influencing factors.

Laboratory parameter-based machine learning model for excluding non-alcoholic fatty liver disease (NAFLD) in the general population.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) affects 20%-40% of the general population in developed countries and is an increasingly important cause of hepatocellular carcinoma. Electronic medical records facilitate large-scale epidemiological studies, existing NAFLD scores often require clinical and anthropometric parameters that may not be captured in those databases. AIM: To develop and validate a laboratory parameter-based machine learning model to detect NAFLD for the general population. METHODS: We randomly divided 922 subjects from a population screening study into training and validation groups; NAFLD was diagnosed by proton-magnetic resonance spectroscopy. On the basis of machine learning from 23 routine clinical and laboratory parameters after elastic net regulation, we evaluated the logistic regression, ridge regression, AdaBoost and decision tree models. The areas under receiver-operating characteristic curve (AUROC) of models in validation group were compared. RESULTS: Six predictors including alanine aminotransferase, high-density lipoprotein cholesterol, triglyceride, haemoglobin A1c , white blood cell count and the presence of hypertension were selected. The NAFLD ridge score achieved AUROC of 0.87 (95% CI 0.83-0.90) and 0.88 (0.84-0.91) in the training and validation groups respectively. Using dual cut-offs of 0.24 and 0.44, NAFLD ridge score achieved 92% (86%-96%) sensitivity and 90% (86%-93%) specificity with corresponding negative and positive predictive values of 96% (91%-98%) and 69% (59%-78%), and 87% of overall accuracy among 70% of classifiable subjects in the validation group; 30% of subjects remained indeterminate. CONCLUSIONS: NAFLD ridge score is a simple and robust reference comparable to existing NAFLD scores to exclude NAFLD patients in epidemiological studies.

[Practices and effects of different measures for blood pressure control in hypertension patients in Beijing, 2014].

Objective: To understand the practices and effects of different measures for blood pressure control in hypertension patients. Methods: Patients who have known hypertension from the subjects of "2014 Beijing adult (aged 18-79 years) chronic diseases and risk factors survey" were selected. The choices of different hypertension control measures, the relationship between the measures and demographic characteristics of hypertension patients, and the effects of different control measures were analyzed. Results: A total of 2 229 known hypertension patients were included, the analysis was conducted through a questionnaire survey. Those who answered "never taking any measures" , "taking medication according to doctor's instructions" and "taking medication when blood pressure rose" accounted for 7.0%, 79.8% and 8.3%, respectively. Those who had "diet control" , "physical exercises" and "blood pressure monitoring" accounted for 22.4%, 23.7% and 22.1%, respectively. In terms of "taking medicine according to doctor's instructions" , women (84.3%), those aged ≥60 years (87.6%), those living in urban area (81.5%), those living alone (83.8%), and Beijing local residents (82.3%) had higher compliance rates. As for "diet control" , women (24.4%), those aged ≥60 years (25.8%) and those with educational level of college or above (29.5%) had better practices. In terms of "physical exercise" , those aged ≥60 years (27.9%), those living in urban area (25.3%), those with educational level of college or above (32.5%) had better practice. Women (24.2%) and those aged ≥60 years (28.4%) had higher "blood pressure monitoring" rate. More men (9.7%), those aged 18-44 years (14.7%), those with educational level of high school (9.3%), the unmarried (18.2%), and non-Beijing local residents (14.7%) answered "never taking any measure" , and in terms of "taking medication when blood pressure rose" , non-Beijing local residents (12.8%) had higher rate. In the field survey, more patients who never took any measure (98.1%) had higher blood pressure than those who took control measures (67.1%), and those who took medicine according to doctor's instructions had lowest blood pressure rise rate (63.9%). Conclusions: Most hypertension patients could take medication according to doctor's instructions, but less patients received other comprehensive intervention measures, and there were still some patients never took any control measure, or took medication only when blood pressure rose. "Taking medication according to doctor's instructions" showed a significant effect in blood pressure control.

[Current smoking status and awareness of tobacco hazard in adults in Beijing, 2014].

Objective: To understand the status of current smoking and awareness of hazard in adults in Beijing, 2014. Methods: A total of 19 815 subjects were randomly selected with stratified multi-stage cluster sampling from 180 communities of 36 townships of 16 districts in Beijing. Each subject received a standardized questionnaire interview. Results: The current smoking rate of the adults was 26.6% (5 253/19 738), which was higher in men (52.2%) than in women (3.6%) and higher in suburb area (28.9%) than in urban area (25.0%). The adults aged 50-59 had higher rate of current smoking. The daily smoking rate was 23.7% (4 677/19 738). The average age when smoking started was 19.2 years. On average, one smoker consumed 15.2 cigarettes per day. The average score for smoking hazard awareness was 5.8, which was higher in smokers than in non-smokers (5.5 vs. 6.0) (t=-9.854, P=0.000). In the smokers, 5.7% (298/5 213) intended to give up smoking within one month. Doctors gave advice to stop smoking for 66.0% of current smokers. The current smoking rate of patients with chronic disease was 31.8% (3 703/11 628), and 5.5% (202/3 686) of them intended to stop smoking within one month. Conclusions: The smoking rate was still high in men in Beijing. The age of starting smoking every day decreased among younger people. The levels of awareness of tobacco hazard and passive smoking were still low. The willingness of smoking cessation was low. The rate of doctor giving smoking cessation advice was low.

The immune response of turbot, Scophthalmus maximus (L.), skin to high water temperature.

The immune responses of mucus from the skin of turbot, Scophthalmus maximus, were studied in relation to changing water temperature. Groups of fish were exposed to a programmed increase of 3 °C per 48 h, until the experimental water temperatures of 16, 20, 23, 25, 27 or 28 °C were reached. After 48 h at the relevant temperature, the expressions of immune-related factors were determined, including immunoglobulin M (IgM), IL-1ß, hepcidin, transferrin, lysozyme, acid/alkaline phosphatase and superoxide dismutase using RT-PCR and spectrophotometric methods. Significant changes in mucus immunity were observed, which paralleled with those previously reported for serum in other fish species. Hence, it is suggested that the serum and mucus immune system of turbot have a similar regulatory system. This information could be useful in better understanding the role of the mucus as a component of the innate immune system.