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BACKGROUND: The aim of this study is to explore the influence of GPs'information, motivation and behavior skills on EM prescribing behavior in urban and suburban districts. METHOD: A cross-sectional study was conducted from June to November 2022 cross 3 urban districts and 4 suburban districts in Beijing. The structural equation model was used to analyze the factors influencing the essential medicine prescription behavior among general practitioners in urban and suburban districts. RESULTS: A total of 511 valid questionnaires were collected. There was a statistically significant difference in mean scores for personal motivation and behavioral skills between urban GPs and suburban GPs. For urban GPs, the path analysis revealed that the social motivation had a direct effect on the essential medicine prescribing behavior (ß = 0.225, p < 0.05). In contrast, for suburban GPs, both social motivation and personal motivation had a direct effect on the essential medicine prescribing behavior, respectively (ß = 0.175, p < 0.05; ß = 0.193, p < 0.01). CONCLUSION: Social motivation of urban GPs were positively and significantly associated with essential medicine prescribing behavior. Social motivation and personal motivation of suburban GPs were positively and significantly associated with essential medicine prescribing behavior. Therefore, various corresponding policies and measures should be developed to promote the National Essential Medicines Policy in China.
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Médicos Generales , Motivación , Pautas de la Práctica en Medicina , Humanos , Estudios Transversales , Médicos Generales/psicología , Masculino , Femenino , Pautas de la Práctica en Medicina/estadística & datos numéricos , Beijing , Persona de Mediana Edad , Adulto , Encuestas y Cuestionarios , Medicamentos Esenciales/uso terapéutico , Análisis de Clases Latentes , China , Actitud del Personal de SaludRESUMEN
BACKGROUND: As the number of elderly migrants in China continues to grow, it is necessary to pay closer attention to their health and health services. Some studies have confirmed that social capital plays a significant role in the utilization of health services. Therefore, an in-depth exploration of the relationship between social capital and the utilization of essential public health services (EPHS) by elderly migrants will not only contribute to improving their overall health but also facilitate a more balanced development of public health service system in China. METHODS: Based on the cross-sectional data from the 2017 China Migrants Dynamic Survey (CMDS), this study examined the impact of social capital on the utilization of EPHS among elderly migrants. We evaluated social capital at two distinct levels: the individual and the community, and considered two dimensions of social capital: structural social capital (SSC) and cognitive social capital (CSC). The study aimed to delve into the impact of these forms of social capital on the utilization of EPHS among elderly migrants, and whether the migration range moderates this impact by multilevel logistic regression analysis. RESULTS: A total of 5,728 migrant elderly individuals were selected. The health records establishment rate and health education acceptance rate were approximately 33.0% and 58.6%, respectively. Social capital influenceed the utilization of EPHS among elderly migrants. Specifically, individual-level SSC and CSC have impacts on both the establishment of health records (OR = 1.598, 95%CI 1.366-1.869; OR = 1.705, 95%CI 1.433-2.028) and the acceptance of health education (OR = 1.345, 95%CI 1.154-1.567; OR = 2.297, 95%CI 1.906-2.768) among elderly migrants, while community-level SSC only affected the acceptance of health education (OR = 3.838, 95%CI 1.328-11.097). There were significant differences in individual-level SSC, health records, and health education among different migration range subgroups among elderly migrants. Migration range moderated the effect of social capital on the utilization of EPHS, crossing provinces could weaken the relationship between SSC and health education. CONCLUSIONS: Social capital is associated with a higher utilization rate of EPHS among elderly migrants. It is necessary to encourage them to actively participate in social activities, strengthen public services and infrastructure construction in the area, and improve their sense of belonging and identity.
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Capital Social , Migrantes , Humanos , China , Masculino , Anciano , Femenino , Migrantes/estadística & datos numéricos , Migrantes/psicología , Estudios Transversales , Persona de Mediana Edad , Modelos Logísticos , Encuestas y Cuestionarios , Aceptación de la Atención de Salud/estadística & datos numéricos , Anciano de 80 o más AñosRESUMEN
Future active metamaterials for reconfigurable structural applications require fast, untethered, reversible, and reprogrammable (multimodal) transformability with shape locking. Magnetic control has a superior advantage for fast and remotely controlled deployment; however, a significant drawback is needed to maintain the magnetic force to hold the transformation, limiting its use in structural applications. The shape-locking property of shape-memory polymers (SMPs) can resolve this issue. However, the intrinsic irreversibility of SMPs may limit their reconfigurability as active metamaterials. Moreover, to date, reprogrammable methods have required high power with laser and arc welding proving to be energy-inefficient control methods. In this work, a magneto-thermomechanical tool is constructed and demonstrated, which enables a single material system to transform with untethered, reversible, low-powered reprogrammable deformations, and shape locking via the application of magneto-thermomechanically triggered prestress on the SMP and structural instability with asymmetric magnetic torque. The mutual assistance of two physics concepts-magnetic control combined with the thermomechanical behavior of SMPs is demonstrated, without requiring new materials synthesis and high-power energy for reprogramming. This approach can open a new path of active metamaterials, flexible yet stiff soft robots, multimodal morphing structures, and mechanical computing devices where it can be designed in reversible and reprogrammable ways.
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The decoction turns into a complex multiphase system following exposure to high temperature and a complex chemical environment. However, the differences in the concentration of key active ingredients in different phase states and the release of drugs in sedimentary phase have yet to be elucidated. A simple ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated for the simultaneous quantitative determination of brucine, strychnine, liquiritin, isoliquiritin, isoliquiritigenin and glycyrrhizic acid concentrations and it was applied to compare the content of different phases and measure the release characteristics of the sedimentary phase in "Glycyrrhiza glabra-Nux vomica" decoction (NGD). The results show that the method's selectivity, precision (intraday and interday ≤ 2%), matrix effect (101-108%), recovery and stability results were acceptable according to the guidelines. The method is sensitive and reliable. The content determination results show that the most toxic strychnine in the sedimentary phase accounted for 75.70% of the total components. The different components exhibited differential release in different media, and its components were released in the artificial intestinal fluid up to 81.02% in 12 h. Several components conformed to the primary kinetic model and the Ritger-Peppas model, and the most toxic compound exhibited slow release, thus conforming to the Ritger-Peppas model. This study provides a standard of reference for studies investigating reduction in toxicity of the combination of Glycyrrhiza glabra (Glycyrrhiza glabra L.) and Nux vomica (Strychnos nux-vomica L.).
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Strychnos nux-vomica , Cromatografía Líquida de Alta Presión , Cromatografía Liquida , Ácido Glicirrínico/análisis , Semillas/química , Estricnina/química , Strychnos nux-vomica/química , Espectrometría de Masas en TándemRESUMEN
OBJECTIVES: This qualitative study aimed to explore the factors influencing the prescription patterns of essential medicines (EMs) from the perspectives of general practitioners (GPs) and patients in Beijing, China. DESIGN: The qualitative study was conducted using individual in-depth interviews. SETTING: This study was conducted from January to August 2020, in community health service centres (CHSCs) across six urban districts of Beijing, China. PARTICIPANTS: A total of 17 GPs from 17 CHSCs in 6 urban districts and 22 patients with non-communicable diseases from three CHSCs in the three urban districts of Beijing were recruited using the purposive sampling method and a three-stage sampling strategy, respectively. RESULTS: Five major themes were identified among factors influencing the prescription pattern of EMs: (1) efficacy and safety of medicines, (2) prescription recommendations from physicians in tertiary or secondary hospitals, (3) patients' medication preference, (4) financial status of patients and (5) minimum requirement for the prescription of EMs. CONCLUSION: The findings of this study contribute to our understanding of the factors influencing the prescription patterns and utilisation of EMs from the perspectives of GPs and patients, respectively. Policymakers should implement policies and measures to promote the National Essential Medicines System in China.
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Médicos Generales , Actitud del Personal de Salud , China , Centros Comunitarios de Salud , Humanos , Prescripciones , Investigación CualitativaRESUMEN
BACKGROUND: In an era of an increasingly ageing society, part of healthcare for older adults can be provided in patients' homes, and the need for home health care services (HHCSs) is increasing. This study sought to determine whether a gap exists between the views of community health professionals and the caregivers of disabled older adults towards HHCSs in Beijing, China. METHODS: A cross-sectional study with two comparative questionnaire surveys was conducted in Beijing, China. One survey was administered to the caregivers of disabled older adults, and the other was administered to health professionals in community health service institutions (CHSIs). T-tests and Wilcoxon signed-rank tests were used to explore potential differences between the views of caregivers and community health professionals towards HHCSs. RESULTS: We received 370 valid questionnaires from caregivers and 224 questionnaires from health professionals. Of the 370 caregivers, 314 (84.9%) were willing to apply for HHCSs for the older adults, but only 20.5% (N = 76) received HHCSs. Over 80% of the caregivers accepted out-of-pocket costs less than 100 yuan per visit. Caregivers' demands on home nursing services were significantly higher than those of health guidance services (Z = - 7.725, P < 0.001). Most of the 224 health professionals chose "health professionals' personal safety cannot be guaranteed" as a problem limiting the provision of HHCSs (N = 151, 40.8%). The health professionals' attitudes towards home nursing services were significantly less positive than those towards health guidance services (Z = - 10.081, P < 0.001). For home nursing services, health professionals' attitude scores were lower than the caregivers' demand scores (Z = - 4.960, P < 0.001), while for health guidance services, health professionals' attitude scores were higher than the caregivers' demand scores (Z = - 8.373, P < 0.001). CONCLUSIONS: Gaps exist between the views of caregivers and health professionals on HHCSs. Compared to health professionals with a higher willingness to provide health guidance services, caregivers need home nursing services. Feasible policies should be implemented to safeguard the rights and interests of health professionals, and qualified health professionals should be trained for HHCSs.
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Cuidadores , Servicios de Atención de Salud a Domicilio , Anciano , Beijing , China , Estudios Transversales , Humanos , Salud PúblicaRESUMEN
BACKGROUND: Domestic migration poses a challenge for China as migrants have little access to preventive healthcare services and are vulnerable to certain risks and diseases. This research sought to unveil and explore the determinant factors associated with health education utilization as a key aspect in basic public health services for migrants in Beijing, China. METHODS: A sample of 863 inter-provincial migrants, 18 years old and above, was selected by three-stage stratified cluster sampling method in urban-rural fringe areas of Beijing during 2016 to 2017. Face-to-face structured interviews were conducted in the questionnaire survey. The effects of the explanatory variables on health education utilization from predisposing, enabling, health behaviors and need variables were used to demonstrate by Anderson health service utilization model. RESULTS: The study revealed that 61.6% migrants desired to receive health education, while only 53.8% of them received in the past year. There were differences in the utilization and needs of health education among the migrants in different ages and genders. Many migrants desired to gain access to various types of health education information from the internet. Chi-square independence test lists such major determinant factors in migrants whole health education as age, "Hukou" registration system, marital status, education level, long-term residence plan in Beijing, one or more children in Beijing, employment status, housing source, average daily working time, exercises, health knowledge, smoking, self-rated health. The binary logistic regression indicates that the migrants with younger age, high education level, one or more children in Beijing, exercises and good self-rated health were more likely to receive whole health education. The results also show that average daily working time of enabling variables and exercise of health behavior variables were the strong and consistent determinants of three types of health education utilization, including communicable, non-communicable and occupational diseases. CONCLUSION: Gaps exist between the needs and utilization in health education and more attention should be given to the migrants with heavy workload and low education level. Feasible policies and measures, such as multiple health information channels, should be vigorously implemented to ensure equitable and easy access to health education for migrants.
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Migrantes , Beijing , China , Estudios Transversales , Utilización de Instalaciones y Servicios , Femenino , Educación en Salud , Humanos , Masculino , Población RuralRESUMEN
OBJECTIVES: We aimed to assess the age-dependent association of obesity with the risk of developing diabetes mellitus (DM) among a low-income population in China. METHODS: In this prospective cohort study, we estimated the hazard ratios (HR) for the association of body mass index (BMI) with DM risk from 1991 to 2014, after adjusting for other possible risk factors, using Cox-regression analysis. RESULTS: A total of 971 participants were followed up for 23 years in this study. The incidence of DM in this population was as high as 467.0/100,000 person-years. Compared with normal weight, the HR (and 95% confidence interval [CI]) for overweight affecting DM risk was 2.23 (1.45-3.41) overall, including 2.43 (1.05-5.63) for men and 2.17 (1.31-3.59) for women. The HR associated with the impact of obesity was 3.59 (2.06-6.27) overall, including 6.04 (1.84-19.81) for men and 3.23 (1.69-6.16) for women. Being overweight had a significant association with DM for people aged 40-49 years (HR, 1.99; 95% CI, 1.03-3.84); the HR for an association between DM and obesity was the highest among individuals aged 30-39 years (HR, 4.43; 95% CI, 1.84-10.67). There was no statistical significance between BMI and DM among individuals aged ≥50 years. CONCLUSIONS: These findings suggest that obesity is associated with developing DM in rural China, especially among adults aged <50 years. Weight management is the highest priority for reducing the heavy burden of DM.
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Diabetes Mellitus Tipo 2/epidemiología , Obesidad/epidemiología , Factores de Edad , Edad de Inicio , Infecciones de Transmisión Sanguínea , Índice de Masa Corporal , China/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Sobrepeso/epidemiología , Estudios Prospectivos , Análisis de Regresión , Factores de Riesgo , Población Rural/estadística & datos numéricos , Factores Sexuales , Factores SocioeconómicosRESUMEN
BACKGROUND: General practitioners (GPs) play a significant role in dementia care. However, the knowledge and attitudes of them towards dementia care are poorly characterized. The present study aimed to investigate GPs' knowledge, attitudes and skills of dementia care in primary health settings in Beijing. METHODS: A cross-sectional survey was conducted in 27 community health service centers (CHSCs) in Beijing. The GPs' knowledge, attitudes and skills were assessed utilizing the Alzheimer's Disease Knowledge Scale (ADKS), Dementia Care Attitude Scale (DCAS) and self-designed questionnaire, respectively. RESULTS: A total of 341 participants returned the questionnaire. The overall mean score of GPs' dementia knowledge measured by the ADKS was 21.42 (SD = 2.73) out of 30 (71.4%), GPs' attitudes to dementia care was 36.25 (SD = 5.12) out of 50 (72.5%), and GPs' self-confidence on dementia care skills was 53.93 (SD = 9.57) out of 75 (71.9%). GPs' overall knowledge towards dementia care was limited and the attitudes were generally positive. They had low level recognition of their roles towards dementia care. The majority of GPs believed that dementia care was within a specialist's domain not that of general practice. CONCLUSION: GPs demonstrate low levels of dementia knowledge and skills, but express generally positive attitudes towards dementia in this study. It is much needed to translate detailed dementia care handbook, and adequate dementia knowledge training for GPs into practice to improve care outcomes for people with dementia in China. In addition, dementia management should be covered in the national basic package of public health services in primary care.
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Demencia , Medicina General , Médicos Generales , Conocimientos, Actitudes y Práctica en Salud , Atención al Paciente , Mejoramiento de la Calidad/organización & administración , Actitud del Personal de Salud , Beijing/epidemiología , Competencia Clínica , Servicios de Salud Comunitaria/organización & administración , Estudios Transversales , Demencia/epidemiología , Demencia/terapia , Medicina General/métodos , Medicina General/normas , Médicos Generales/normas , Médicos Generales/estadística & datos numéricos , Humanos , Evaluación de Necesidades , Atención al Paciente/métodos , Atención al Paciente/normasRESUMEN
Effect of nano-SiO2 packing on postharvest quality and antioxidant capacity of two different loquat cultivars (white-flesh 'Qingzhong' and red-flesh 'Dawuxing') were determined. Results showed that nano-SiO2 packing significantly inhibited internal browning, retarded the decline of total soluble solids, titratable acidity, ascorbic acid content and extractable juice in both cultivars. Decay index of nano-SiO2 packing in 'Dawuxing' and 'Qingzhong' was 53.25% and 42.84% lower than control after the day 12, respectively. Meanwhile, nano-SiO2 packing enhanced the contents of individual phenolic compounds and soluble sugar compounds, induced higher superoxide dismutase and catalase activities, which contributed to improving 1,1-diphenyl-2-picrylhydrazyl and hydroxyl radical scavenging capacity. Furthermore, the contents of total soluble solids, ascorbic acid and soluble sugar were higher in 'Qingzhong' than those in 'Dawuxing', which dedicated to better quality. These results indicated that nano-SiO2 packing was a promising approach in inhibiting decay, maintaining quality and expanding shelf life of loquats.
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Antioxidantes/farmacología , Eriobotrya/efectos de los fármacos , Dióxido de Silicio/farmacología , Ácido Ascórbico/análisis , Eriobotrya/química , Almacenamiento de Alimentos , Frutas/química , Frutas/efectos de los fármacos , Nanoestructuras , Fenoles/análisis , Superóxido Dismutasa/metabolismo , TemperaturaRESUMEN
Aims: Abnormal glucose regulation, which can present as diabetes and prediabetes, has become one of the most common chronic conditions. However, sex differences in the prevalence of and factors associated with abnormal glucose regulation remain unclear. Thus, we aimed to explore sex differences in the prevalence of and factors associated with abnormal glucose regulation in low-income adults in China aged ≥50 years with normal fasting plasma glucose levels. Materials and Methods: A total of 2,175 individuals aged ≥50 years with normal fasting plasma glucose levels were recruited into this study. After an overnight fast of at least 10 h, individuals underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose levels were measured to determine the state of glucose regulation. Results: Women were more likely than men to have isolated-impaired glucose tolerance (i-IGT) overall (24.7% vs 20.8%; P= 0.034), among individuals aged <65 years (21.7% vs 15.9%; P= 0.012). Among men, independent risk factors for i-IGT were an age of ≥65 years, hypertension, and high serum uric acid (SUA) and triglyceride levels; independent risk factors for diabetes mellitus (DM) were an age of ≥75 years and alcohol consumption. Among women, independent risk factors for i-IGT were central obesity and high levels of high-sensitivity C-reactive protein and SUA; independent risk factors for DM were low education and an elevated white blood cell count. Conclusions: Our findings suggest that conventional cardiovascular disease risk factors (i.e., age, hypertension, and dyslipidemia) associated with high risk of developing DM in men, but poor life style (i.e., obesity) and low education attainment in women. It is necessary for delay or stopping the development of DM among low-income adults in China to implement the personalized scheme of prevention DM between men and women, especially highlight control the risk factors in young and middle aged women.
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Glucemia/metabolismo , Ayuno/sangre , Intolerancia a la Glucosa/epidemiología , Estado Prediabético/epidemiología , Caracteres Sexuales , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Femenino , Intolerancia a la Glucosa/sangre , Prueba de Tolerancia a la Glucosa , Humanos , Hipertensión/sangre , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/epidemiología , Estado Prediabético/sangre , Prevalencia , Factores de Riesgo , Triglicéridos/sangreRESUMEN
BACKGROUND: Evidence-based medicine (EBM) is gradually being recognized worldwide as an important clinical skill and plays an important role in health care. Although the concept has successfully spread in the health care field, EBM still has not been widely incorporated into clinical decisions in primary care due to potential barriers. This study aimed to explore the views, experiences and obstacles of general practitioners (GPs) regarding the use EBM in their daily clinical practices in Beijing. METHODS: We performed a qualitative study with GP focus groups. Thirty-two GPs working in 26 community health service centres in 7 districts in Beijing were recruited. Four focus group sessions with 32 GPs were conducted in a meeting room at the Capital Medical University from January to February in 2018 in Beijing. All sessions were audio-recorded, transcribed and analysed for themes using an inductive content analysis approach. RESULTS: GPs believed that EBM could help them enhance the quality of their clinical practice. The most common EBM behaviour of GPs was making clinical decisions according to guidelines. The barriers that limited the implementation of EBM were patients' poor compliance, lack of time, lack of resources, inadequate skills or knowledge, and guideline production problems. The first need for GPs was to participate in training to enhance their skills in practising EBM. CONCLUSIONS: To practise EBM in general practice, integrated interventions of different levels need to be developed, including enhancing GPs' communication skill and professional competency, training GPs on the implementation of EBM, employing more staff to reduce GPs' workloads, providing adequate resource support, and developing evidence-based clinical guidelines for GPs.
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Actitud del Personal de Salud , Medicina Basada en la Evidencia , Médicos Generales/psicología , Necesidades y Demandas de Servicios de Salud , Adulto , Beijing , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Investigación CualitativaRESUMEN
The relationship between body mass index (BMI) and stroke type has remained controversial despite studies demonstrating that BMI is related to stroke risk, especially in specific groups. We assessed the age- and sex-associated impacts of BMI on stroke type in a low-income, poorly educated population in China. The association of BMI with stroke type was estimated using Cox regression analyses in this prospective cohort study, after adjusting for sex, age, education level, hypertension, diabetes, smoking, and alcohol drinking status. During the follow-up period, 638 stroke cases occurred among the 3,906 participants included in this prospective study. For men aged <65 years, being overweight was an independent predictor of all stroke subtypes, compared with normal-weight individuals; the hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.98 (1.52-2.58) for total stroke, 1.69 (1.22-2.33) for ischemic stroke, and 3.62 (2.09-6.25) for hemorrhagic stroke, all P < 0.001. Being underweight was also an independent predictor of hemorrhagic stroke (HR, 5.10; 95%CI, 1.80-14.50, P = 0.002). For women <65-years-old, being overweight was a risk factor for total (HR, 1.38; 95% CI, 1.01-1.89; P = 0.044) and hemorrhagic strokes (HR, 2.06; 95% CI, 1.00-4.28; P = 0.050); obesity was a risk factor for total (HR, 2.47; 95% CI, 1.60-3.82) and ischemic strokes (HR, 2.53; 95% CI, 1.54-4.15), all P < 0.001. These findings suggest that weight management should be a high priority for substantially reducing the heavy burden of strokes in rural China among both men and women <65-years-old; men<65-years-old should maintain their weight within a reasonable range.
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Glycine betaine (GB) treatment is useful to reduce chilling injury (CI) of several kinds of fruits including peach. However, the regulatory mechanism remains unknown. In this study, peach fruit was treated with 10â¯mmolâ¯L-1 GB solution for 10â¯min. The effects of GB treatment on CI, phenolic and soluble sugar metabolism were investigated in this study. Moreover, phenylpropanoid and soluble sugar content, and enzyme activities associated with phenolic and sugar metabolisms were also measured. The results showed that GB reduced CI and maintained high levels of total phenolic and flavonoid content. The activities of phenylpropanoid metabolism-related enzymes were significantly enhanced by GB. Higher content of sucrose and lower contents of fructose and glucose were observed in GB-treated fruits. Therefore, our results showed that GB could enhance chilling tolerance of peach through regulating phenolic and sugar metabolisms, and maintaining high levels of individual phenolic and sucrose content.
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Betaína/farmacología , Fenoles/metabolismo , Prunus persica/metabolismo , Azúcares/metabolismo , Cromatografía Líquida de Alta Presión , Frío , Fructosa/metabolismo , Frutas/efectos de los fármacos , Frutas/metabolismo , Glucosa/metabolismo , Fenoles/análisis , Fenilanina Amoníaco-Liasa/metabolismo , Prunus persica/efectos de los fármacosRESUMEN
OBJECTIVE: Aldehyde dehydrogenase 2 (ALDH2), a key enzyme to detoxify acetaldehyde in the liver, exists in both active and inactive forms in humans. Individuals with inactive ALDH2 accumulate acetaldehyde after alcohol consumption. However, how acetaldehyde affects T-cell hepatitis remains unknown. DESIGN: Wild-type (WT) and Aldh2 knockout (Aldh2-/-) mice were subjected to chronic ethanol feeding and concanavalin A (ConA)-induced T-cell hepatitis. Effects of acetaldehyde on T-cell glucose metabolism were investigated in vitro. Human subjects were recruited for binge drinking and plasma cortisol and corticosterone measurement. RESULTS: Ethanol feeding exacerbated ConA-induced hepatitis in WT mice but surprisingly attenuated it in Aldh2-/- mice despite higher acetaldehyde levels in Aldh2-/- mice. Elevation of serum cytokines and their downstream signals in the liver post-ConA injection was attenuated in ethanol-fed Aldh2-/- mice compared to WT mice. In vitro exposure to acetaldehyde inhibited ConA-induced production of several cytokines without affecting their mRNAs in mouse splenocytes. Acetaldehyde also attenuated interferon-γ production in phytohaemagglutinin-stimulated human peripheral lymphocytes. Mechanistically, acetaldehyde interfered with glucose metabolism in T cells by inhibiting aerobic glycolysis-related signal pathways. Finally, compared to WT mice, ethanol-fed Aldh2-/- mice had higher levels of serum corticosterone, a well-known factor that inhibits aerobic glycolysis. Blockade of corticosterone partially restored ConA-mediated hepatitis in ethanol-fed Aldh2-/- mice. Acute alcohol drinking elevated plasma cortisol and corticosterone levels in human subjects with higher levels in those with inactive ALDH2 than those with active ALDH2. CONCLUSIONS: ALDH2 deficiency is associated with elevated acetaldehyde and glucocorticoids post-alcohol consumption, thereby inhibiting T-cell activation and hepatitis.
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Aldehído Deshidrogenasa Mitocondrial/fisiología , Consumo Excesivo de Bebidas Alcohólicas/metabolismo , Glucosa/metabolismo , Hepatitis/metabolismo , Hepatitis/prevención & control , Linfocitos T/fisiología , Animales , Consumo Excesivo de Bebidas Alcohólicas/patología , Concanavalina A , Corticosterona/sangre , Modelos Animales de Enfermedad , Etanol , Hepatitis/etiología , Humanos , Hidrocortisona/sangre , RatonesRESUMEN
BACKGROUND: Informal caregivers of people with dementia in Beijing are increasingly called upon to provide home-based care for their patients due to the increasing number of dementia patients and the shortage of standardized institutional solutions of care for patients in China. This study aimed to clarify the needs of informal caregivers and barriers of primary care workers toward dementia management in primary care in Beijing to provide references that may help to improve the care and services provided to individuals with dementia and their family caregivers residing in urban China. METHODS: A mixed-methods approach was used in this study. We performed individual in-depth interviews with 10 informal caregivers. Moreover, we carried out focus group interviews with 29 primary care workers. Content analysis was used to separately identify themes and codes. Discrepancies were discussed until final agreement was achieved. RESULTS: Three themes representing the core attitudes of informal caregivers and primary care workers were identified: care knowledge and skills, psychological counseling, and collaborative management. Most primary care workers believed that the management of dementia patients in primary care was necessary. However, due to the heavy work load and different medical specialties involved, these workers were unable to manage it. CONCLUSIONS: Professional training focused on dementia for primary care workers should be strengthened. At the same time, the establishment of a community-based dementia team management model that includes specialists, community health service centers (CHSCs), and community committees should be explored.
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Cuidadores , Demencia , Personal de Salud , Servicios de Atención de Salud a Domicilio , Capacitación en Servicio , Atención Primaria de Salud , Anciano , Actitud del Personal de Salud , Cuidadores/psicología , Cuidadores/estadística & datos numéricos , China/epidemiología , Demencia/epidemiología , Demencia/terapia , Femenino , Grupos Focales , Personal de Salud/educación , Personal de Salud/psicología , Servicios de Atención de Salud a Domicilio/organización & administración , Servicios de Atención de Salud a Domicilio/normas , Humanos , Capacitación en Servicio/métodos , Capacitación en Servicio/normas , Masculino , Evaluación de Necesidades , Atención Primaria de Salud/métodos , Atención Primaria de Salud/normas , Investigación Cualitativa , Mejoramiento de la CalidadRESUMEN
BACKGROUND: The Chinese government offered various types of training programs for strengthening the role of doctors working in community health service institutions (CHSIs). The study intended to investigate the current training programs and training needs of doctors nationally in urban CHSIs in China, and to provide propositions for training more qualified doctors in the future. METHODS: Total 3098 doctors in 192 urban CHSIs were chosen from 9 provinces (Hebei, Liaoning, Shandong, Zhejiang, Fujian, Hunan, Guangxi, Guizhou, Ningxia) and one municipality (Beijing) among 31 provinces in eastern, central, and western regions by stratified sampling methods in Mainland China. All doctors in the selected CHSIs were investigated in this study. We discharged 3073 questionnaires, and the response rate was 98.0%. Descriptive statistics were used to describe the characteristics, training contents, problems and needs of doctors. Differences in training contents, problems and needs between eastern, central and western regions were analyzed with chi-square tests. RESULTS: 49.3% of doctors in CHSIs had Bachelor's degree and beyond. 12.9% of doctors had senior professional titles. The most frequent training topics for the doctors in eastern, central and western regions were "basic clinical theory knowledge" (52.4%), "community health service competency" (59.6%), "clinical practice skills" (45.9%) respectively. The most serious problem for doctors was "insufficient training time" in eastern (36.8%), central (36.5%) and western (39.6%). The biggest knowledge need for doctors both in eastern (79.8%) and central region (79.1%) was "the updated international medical knowledge", in western region it was "the updated domestic medical knowledge" (73.2%). The biggest skill-related training need for doctors in eastern region (84.1%) and central region (82.6%) was "communication skills", and "diagnosis and differential diagnosis" in western region (78.2%). CONCLUSION: Government should design proper training contents according to the knowledge and skill needs of different design. Furthermore, a uniform, rigorous training and evaluation system focus on practicability should be established to promote community health service system in Mainland China.
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Actitud del Personal de Salud , Competencia Clínica , Servicios de Salud Comunitaria/organización & administración , Agentes Comunitarios de Salud/educación , Educación Continua/organización & administración , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Servicios Urbanos de Salud/organización & administración , China , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
Herein, a novel and convenient electrochemically active-inactive switching molecular beacon based on hemin (Hs-MB) has been designed for easy discrimination of single nucleotide polymorphisms (SNPs) and sensitive detection of insulin. The electrochemically active changing capability of Hs-MB is based on two identical hemin groups labeled at both ends of MB sequence in dimer or monomer forms depending on the conformation of MB which is in stem-loop structure or line shaped structure. The Hs-MB assay permits discrimination of SNPs and the highly sensitive and specific detection of insulin with detection limit successively as low as 0.5 pmol/L. Even at a very low target concentration, the Hs-MB assay also shows a good specificity in the presence of other potentially interfering components. The experimental results also show that Hs-MB can also be used for the accurate and rapid monitoring of insulin secretion by glucose-stimulated from MIN6 cells at different time periods, demonstrating that Hs-MB has potential in monitoring of biomarker variation in vivo.
Asunto(s)
Técnicas Biosensibles/métodos , Hemina/química , Insulina/análisis , Insulina/genética , Sondas de Oligonucleótidos/química , Polimorfismo de Nucleótido Simple , Línea Celular , Electroquímica , Glucosa/farmacología , Insulina/química , Insulina/metabolismo , Secreción de Insulina , Límite de Detección , SolucionesRESUMEN
BACKGROUND: Migrants are the unique production of China's urbanization process. They are often excluded from social welfare and security systems of cities, and often exposed to high health risk related closely to their health problems. This research sought to unveil and explore the influencing factors on health services utilization of migrants in Beijing. METHODS: A sample of 2014 inter-provincial migrants and 4578 residents with Beijing "Hukou" who were 15 years old and above was chosen by three-stage stratified cluster sampling method. A structured questionnaire survey was conducted via face-to-face interviews. Anderson health service utilization model was used to demonstrate the effects of the explanatory variables on health seeking behavior from predisposing, enabling and need variables. RESULTS: The study reveals that the rate of 'having symptoms' of migrants was lower than that of residents with "Hukou" only in the group of 25 to 34 years old in the past month. 503 migrants (25.0%) and 1441 (31.5%) residents with "Hukou" reported at least one episode of discomfort in the past month, and the rate of health service seeking behavior among migrants (46.8%) was lower than residents with "Hukou" (62.6%) (P < 0.0001). Chi-square independence test shows that age, ethnicity, employment status, having chronic disease and the degree of symptom were the major determinants affecting migrants to receive health services. The binary logistic regression indicates that the degree of symptom as the need variable and ethnicity as the predisposing variable were the strong and consistent determinants of health services seeking behavior. The migrants with moderate degree and severe degree of symptom in the past month were at 1.623-times (OR = 1.623) and 5.035-times (OR = 5.035) higher chances of seeking health services respectively, comparing to mild degree of symptom. Minority migrants were less likely to seek health services than Han migrants (OR = 0.282). CONCLUSIONS: The results indicate that the current health delivery system is not conducive for migrants to seek appropriate health services. Relevant policies and feasible measures, including increasing the coverage of health insurance and improving the health perception of migrants should be vigorously implemented to provide affordable health services and change health service utilization behaviors for migrants.
Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Servicios de Salud del Trabajador , Aceptación de la Atención de Salud/estadística & datos numéricos , Migrantes , Adolescente , Adulto , Beijing/epidemiología , Estudios Transversales , Atención a la Salud/estadística & datos numéricos , Empleo , Femenino , Investigación sobre Servicios de Salud , Humanos , Modelos Logísticos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND AND AIMS: Increased volume of visceral adipose tissue is associated with worsening of cardiovascular disease risk factors that contribute to aortic dilatation. We investigated the effects of visceral fat index (VFI) and VFI/percentage body fat (PBF) ratio on proximal aortic size and proximal aortic dilatation (PAD), to assess whether excess visceral fat deposition is an independent risk factor for PAD. METHODS: 738 participants aged 35 years or more were included in this cross-sectional survey. The sizes of aortic valve annulus (AVA), sinuses of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AscAo) were measured by transthoracic ultrasound. Multivariate linear regression, binary logistic regression, Bayesian linear regression, and receiver operating characteristic curves were performed to clarify the effects of VFI and VFI/PBF ratio on PAD. RESULTS: There were 78 participants (10.6%) with PAD. VFI and VFI/PBF ratio in the population with PAD was significantly increased, compared to the population without PAD (p < 0.001). However, PBF was not significantly different between the two populations. VFI/PBF ratio was positively associated with sizes of AVA, SV, STJ, and AscAo (p < 0.05), and was independently related to PAD (p < 0.05). A 1-SD increment in VFI/PBF ratio was associated with 13.35-fold increased risk of PAD (odds ratio: 13.35, p < 0.05). CONCLUSIONS: VFI/PBF ratio is independently associated with PAD. An increased proportion of visceral fat may contribute to PAD. VFI/PBF ratio calculation may be used for the preliminary identification of individuals at high risk of PAD in the Chinese population.