Individual-Level Health Care Costs Attributable to Noncommunicable Diseases: A Longitudinal Study Based on the Older Adults in China.

Noncommunicable chronic diseases among the elderly population represent a significant economic burden in China. However, previous disease-related health cost studies lacked representation of older adults and comparability of the burden of multiple chronic diseases. The objective of this study was to determine the fraction of health care costs attributable to the 6 most prevalent chronic diseases and comorbidities in the sample of older adults. This study employed data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with 3 waves in 2011, 2014, and 2018, and included 18 349 observations in total. Outpatient costs, inpatient costs, and total health care costs were included in this study. Based on a 2-part random effects model, the effect of chronic disease on health service utilization was first explored by constructing a dummy variable for whether or not to utilize health care, followed by estimation of attributable costs in the population with health care utilization. Among the older adults in the sample, hypertension, heart disease, cataracts, arthritis, stroke or Cerebrovascular disease (CVD) and chronic lung disease are the 6 most prevalent chronic conditions. The costs attributable to the 6 chronic diseases mentioned above were 36.00% of outpatient costs, 55.92% of inpatient costs, and 45.05% of total health care costs for older adults. Of these, heart disease, stroke or CVD, and chronic lung disease accounted for 22.11%, 13.24%, and 10.56% of total health care costs, respectively. Moreover, the proportion of health care costs attributable to chronic diseases was higher for older adults who were male, lived in urban areas, and had a lower level of education. The proportion of health care costs attributable to chronic diseases is substantial among older adults in China. Health care costs associated with chronic diseases can be decreased with well-targeted interventions and comprehensive access to health services.

Convergence mechanism of mindfulness intervention in treating attention deficit hyperactivity disorder: Clues from current evidence.

This paper reviews the underlying evidence for various aspects of the convergence mechanism of mindfulness intervention in attention deficit hyperactivity disorder (ADHD). There may be compatibility among various ADHD remission models and the therapeutic mechanism of mindfulness intervention in ADHD may be mainly via the convergence mechanism. However, neuroimaging-based analysis of the mechanisms of mindfulness intervention in treating ADHD is lacking. Differences in the efficacy of various subtypes of mindfulness intervention, and corresponding specific imaging changes need further investigation. Future research may focus on the neuroimaging features of specific mindfulness intervention subtypes.

Behavioral Intention and Its Predictors toward COVID-19 Booster Vaccination among Chinese Parents: Applying Two Behavioral Theories.

The booster vaccination of COVID-19 is being implemented in most parts of the world. This study used behavioral psychology to investigate the predictors of parents' intentions regarding the COVID-19 booster vaccination for their children. This is a cross-sectional study with a self-designed questionnaire based on two behavioral theories-protective motivation theory (PMT) and theory of planned behavior (TPB). A stratified multi-stage sampling procedure was conducted in Nanjing, China, and multivariable regression analyses were applied to examine the parents' intentions. The intention rate was 87.3%. The response efficacy (ORa = 2.238, 95% CI: 1.360-3.682) and response cost (ORa = 0.484, 95% CI: 0.319-0.732) in the PMT, were significant psychological predictors of parents' intentions, and so were the attitude (ORa = 2.619, 95% CI: 1.480-4.636) and behavioral control (ORa = 3.743, 95% CI: 2.165-6.471) in the TPB. The findings of crucial independent predictors in the PMT and TPB constructs inform the evidence-based formulation and implementation of strategies for booster vaccination in children.

[Adsorption Behavior of Phosphate by CaO2 Remolded Sediment].

This study simulated the state of CaO2 loss after in situ coverage and examined the bottom 2 cm of sediment after restoration. Observations and elemental analysis of the sediment using scanning electron microscopy (SEM) and X-ray energy spectrometry (EDX) were also performed. The CaO2 remodeling notably changed the structure of the sediment; most of the organic matter and iron-manganese oxide attached to the sediment surface was removed, the porosity of the sediment particles increased, and the Ca2+ content was also increased. CaO2 remodeling stabilized the endogenous phosphorus in the sediment; total phosphorous (TP) was reduced by approximately 20% and potential active phosphorus content was reduced by approximately 30%. Furthermore, the contents of Ca-P and Res-P were significantly increased. The amount of phosphorus released from the remodeled sediment under anaerobic conditions was significantly lower than the original sediment, indicating that the CaO2 remodeling greatly reduced the risk of endogenous phosphorus release. The Langmuir model was more suitable than the Freundlich and Dubinin-Radushkevich models for describing the isothermal adsorption behavior of the CaO2 remodeling, which significantly improved the adsorption capacity of the sediment with respect to phosphate from 1.44 mg·g-1 to 20.91 mg·g-1. The mechanism of adsorption was switched from chemical adsorption to physicochemical adsorption. In addition, the adsorption kinetics of the CaO2 remodeled sediment with respect to phosphate could be best described using the quasi-second-order kinetic model.

[Effect of Calcium Peroxide Composite Tablets on Water Remediation and Phosphorus Control in Sediment].

Two types of calcium peroxide composite tablets (CPCTs) were prepared, and the inhibition effect on the release of endogenous phosphorus and the influence on the overlying water by mixed-dosing were investigated. The CPCTs were made of calcium peroxide (CaO2), calcined water purification sludge, and hydroxypropyl methylcellulose (HPMC), which were directly pressed into composite tablets, among which Tablet-B (T-B) contained ferrous sulfate (FeSO4) and Tablet-A (T-A) did not. Both the tablets agreed well with the Langmuir and Freundlich isothermal models; the theoretical maximum adsorption capacities of T-A and T-B on phosphorus were 110.908 mg·g-1 and 106.390 mg·g-1, respectively. Compared with the control group, the pH of overlying water was increased, the concentration of Chl-a was decreased by 42.75% and 60.82%, and the DO was increased by 53.73% and 63.30% in group A and B, respectively. The DIP of the overlying water decreased significantly by 54.93% and 25.11% in group A and B, respectively. For the interstitial water in sediment, the DIP in layer Ⅰ (0-2 cm) decreased significantly by 74.81% and 65.66% in group A and B, and the DIP in layer Ⅱ (2-4 cm) decreased significantly by 46.23% in group B, but not obviously in group A. The DIP in layer Ⅲ (4-6 cm) remained unchanged in group A and B. For phosphorus fractions in sediment, the proportion of NH4Cl-P in TP was significantly increased (layer Ⅰ: 16.87% and 13.11%; layer Ⅱ: 12.99% and 11.02%, in group A and B, respectively), and the proportion of Al-P in TP was significantly decreased (layer Ⅰ: 7.58% and 13.91%; layerⅡ: 9.86% and 7.28%, in group A and B, respectively). The other phosphorus fractions did not change significantly. Both T-A and T-B dosing can improve the microbial activity of the surface sediment, though T-A can improve the microbial activity more significantly.

Factors Associated With Prescribed Antenatal Care Utilization: A Cross-Sectional Study in Eastern Rural China.

With relatively sufficient antenatal health service supplies in eastern rural China, the utilization still needs to be improved. The objective of this study was to identify factors that correlate with antenatal care (ANC) utilization from the demand-side in Jiangsu, China. In a cross-sectional survey, a sample of 896 rural women who had a childbearing history in the previous 5 years answered ANC questions and formed the final analysis. Questionnaire was designed based on Andersen's behavioral model. The outcome variables included receiving times and items of prescribed ANC utilization, and the explanatory variables were organized into 3 hierarchical levels: predisposing, enabling, and need factors. Univariate analysis and multivariate logistic regression analysis were conducted. In the results of multivariate logistic regression, factors significantly associated with ANC examination times included income, odds ratio (OR) (95% confidence interval [CI]) = 2.90 (1.92-4.39); the distance from the nearest hospital, OR (95% CI) = 0.67 (0.47-0.95); chronic disease, OR (95% CI) = 1.77 (1.15-2.72); and parity, OR (95% CI) = 0.66 (0.46-0.95), while factors significantly associated with ANC examination items included education, OR (95% CI) = 8.02 (1.08-59.67); income, OR (95% CI) = 3.90 (1.72-8.85); female medical staff in towns and villages, OR (95% CI) = 2.64 (1.39-5.02); and parity, OR (95% CI) = 0.41 (0.23-0.75). In reducing inadequate ANC utilization in rural area, efforts should be made not only to target the rural women with lower income, lower educational level, and multi-parity, but also to further improve the accessibility of the primary medical facilities and female staff at the grassroots level.

[Nitrogen cycling and balance for wheat in China].

In this study, the input and output parameters of N for wheat production were collected from published literatures and International Plant Nutrition Institute in the period of 2000 to 2011 to evaluate N cycling and balances in North China, the middle and lower reaches of Yangtze River and Northwest China. The results showed that the N fertilizer application rates for each region were 170, 183 and 150 kg N . hm-2, the amounts of N from the previous crop were 74.6, 15.2 and 8.1 kg N . hm-2, and from seeds were 4.9, 4.2 and 3.5 kg N . hm-2, respectively. The N inputs from symbiotic fixation, atmospheric deposition and irrigation water in North China were 15, 12.9 and 9.9 kg N . hm-2, and in the middle and lower reaches of Yangtze River were 15, 14.5 and 5.8 kg N . hm-2, and in Northwest China were 15, 9.4 and 7.7 kg N . hm-2, respectively. The amounts of N uptake by aboveground plant at harvest time in North China, the middle and lower reaches of Yangtze River and Northwest China were 174.3, 144.4 and 122.3 kg N . hm-2, respectively, and the rates of ammonia volatilization, N20 emission and N leaching in North China were 19.9, 2.6 and 11.8 kg N . hm-2, in the middle and lower reaches of Yangtze River were 9.4, 2.4 and 15.5 kg N . hm-2, and in Northwest China were 3.4, 0.7 and 0 kg N . hm-2, respectively. As a result, the N balances in these three regions were all showing surpluses by 78.7, 66.0 and 67.3 kg N . hm-2. It is therefore necessary to adjust the N fertilizer application rates in these three regions to avoid the negative impacts on the environment.