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BACKGROUND: Anxiety disorders can cause serious physical and psychological damage, so many anxiety scales have been developed internationally to measure anxiety disorders, but due to the cultural differences and cultural dependence of quality of life between Chinese and Western cultures, it is difficult to reflect the main characteristics of Chinese patients. Therefore, we developed a scale suitable for Chinese patients with anxiety disorders: the Anxiety Disorders Scale of the Quality of Life Instruments for Chronic Diseases (QLICD-AD), hoping to achieve satisfactory QOL assessments for anxiety disorders. OBJECTIVES: Items from the Anxiety Disorders Scale of the Quality of Life in Chronic Disease Instrument QLICD-AD system were analyzed using CTT and IRT to lay the groundwork for further refinement of the scale to accurately measure anxiety disorders. METHODS: 120 patients with anxiety disorder were assessed using the QLICD-AD (V2.0). Descriptive statistics, variability method, correlation coefficient method, factor analysis and Cronbach's coefficient of CTT, and graded response model (GRM) of item response theory were used to analyze the items of the scale. RESULT: CTT analysis showed that the standard deviation of each item was between 0.928 and 1.466; Pearson correlation coefficients of item-to-domain were generally greater than 0.5 and also greater than that of item-to-other domain; the Cronbach 's of the total scale was 0.931, α of each domain was between 0.706 and 0.865. IRT analysis showed that the discrimination was between 1.14 and 1.44. The difficulty parameter of all items increased with the increase of grade. But some items (GPH6,GPH8,GPS3,GSO2-GSO4,AD2,AD5) difficulty parameters were less than 4 or greater than 4. The average of information amount was between 0.022 and 0.910. CONCLUSION: Based on CTT and IRT analysis, most items of the QLICD-AD (V2.0) scale have good performance and good differentiation, but a few items still need further revision. Suggests that the QLICD-AD (V2.0) appears to be a valid measure of anxiety disorders. It may effectively improve the diagnosticity of anxiety disorders, but due to the limitations of the current sample, further validation is needed in a broader population extrapolation trial.
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Objective: To evaluate the prevalence and associated factors of undernutrition among children with congenital heart disease (CHD) who have not undergone surgeries in China. Methods: This cross-sectional study included 734 CHD children along with their parents. The outcome of interest was undernutrition, including underweight, wasting, and stunting, defined as Z-scores (i.e., weight-for-age, weight-for-height, and height-for-age) ≤-2, according to the World Health Organization (WHO) growth standard. Exposures of interest, containing demographics, obstetric factors, maternal dietary factors, parents' life behaviors and habits, birth-related factors, cardiac-related factors, and preoperative factors, were analyzed using a multivariate logistic regression model to test their associations with undernutrition in CHD children. Results: Overall, 36.1%, 29.7%, and 21.3% of cases were underweight, wasted, and stunted, respectively. Multivariate logistic regression indicated that underweight was associated with demographic factors (including parents' occupational status, family income, and maternal body mass index pre-pregnancy), low birth weight (OR = 4.60, 2.76-7.70), pulmonary hypertension (OR = 4.46, 3.09-6.43), and pneumonia (OR = 1.88, 1.28-2.76). Artificially-fed children were 2.34 (1.36-4.01) times more likely to be underweight. Occupied mothers (OR = 0.62, 0.44-0.88) and fathers (OR = 0.49, 0.26-0.92) served as protective factors, while mothers having gestational complications (OR = 1.56, 1.11-2.18) and exposed to noisy environment (OR = 1.64, 1.11-2.42) during this pregnancy, and pulmonary hypertension (OR = 3.21, 2.30-4.49) increased the chance of wasting in offspring. The odds of being stunted were greater in families with >2 children (OR = 1.88, 1.13-3.14), placental abruption during this pregnancy (OR = 25.15, 2.55-247.89), preterm births (OR = 1.84, 1.02-3.31), low birth weight (OR = 3.78, 2.16-6.62), pulmonary hypertension (OR = 2.35, 1.56-3.53) and pneumonia (OR = 1.93, 1.28-2.90). In subgroup analyses, the associations differed between patients with different feeding patterns (breastfeeding vs. non-breastfeeding), CHD classifications (cyanotic vs. acyanotic), and prematurity (preterm vs. non-preterm). Conclusion: Undernutrition is common in preoperative CHD children. Familial demographics, maternal factors (including having gestational complications and exposure to noisy environment during pregnancy), and patient-related factors (encompassing preterm births, low birth weight, pulmonary hypertension, pneumonia, and feeding pattern) were found to contribute to undernutrition in CHD cases. However, associated factors among the three subgroups of distinct feeding patterns, CHD categorization, and prematurity exhibited varied outcomes, suggesting the necessity for targeted interventions.
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Research on the processes and mechanisms of compound soil erosion by multiple forces can provide scientific guidance for precisely controlling cropland soil erosion. Based on the seasonal alternation of freezing-thawing, snowmelt, wind, and rainfall erosion forces on sloping farmlands under natural conditions from November to next October of each year, we used a set of indoor simulation experiments of multi-force superimpositions to analyze the compound soil erosion processes of snowmelt (1 and 2 L·min-1), wind (12 m·s-1), and rainfall (100 mm·h-1). We further discussed the erosion effects of multi-force superimpositions. The results showed that, under single snowmelt erosion, an increase in snowmelt flow had a greater effect on sloping snowmelt erosion intensity than that of sloping runoff rate. When sloping snowmelt flow increased from 1 L·min-1 to 2 L·min-1, sloping runoff rate and erosion intensity increased by 2.7 and 4.0 times, respectively. Under snowmelt-wind superimposition erosion, previous sloping snowmelt erosion inhibited late wind erosion occurrence. As sloping snowmelt flow increased from 1 L·min-1 to 2 L·min-1, the inhibiting action subsequently increased and wind erosion intensity caused by previous snowmelt reduced by more than 50%. Both wind erosion and snowmelt-wind superimposed erosion intensified late rainfall erosion. The early wind erosion increased rainfall erosion by 24.5%. The snowmelt-wind superimposed effect increased the later slope rainfall erosion by 132.8% and 465.4% under 1 and 2 L·min-1 snowmelt runoff rates, respectively. The compound soil erosion amount driven by multiple force superimposition was not the sum of the corresponding erosion amount caused by single erosion force, with promoting or inhibiting effects of erosion force superimposition. The erosion effect of snowmelt-wind superposition was negative, but that of wind-rainfall superposition and snowmelt-wind-rainfall superpositions were positive.
Assuntos
Fazendas , Chuva , Neve , Erosão do Solo , Solo , Vento , China , Sedimentos Geológicos , Movimentos da ÁguaRESUMO
Snowmelt erosion is an important way of soil loss in Chinese Mollisol region. However, little is known about the effects of seepage flow and soil thaw depth on hillslope snowmelt runoff erosion. An indoor simulated experiment was conducted to analyze the impacts of seepage flow and soil thaw depth on hillslope snowmelt erosion. There were two snowmelt flow rates (1 and 4 L·min-1), two soil thaw depths (5 and 10 cm), and two near-surface hydrological conditions (with and without seepage flow). The results showed that hillslope runoff depth and soil erosion amount in the treatment with seepage flow were 1.1 to 1.2 times and 1.3 to 1.9 times of those in the treatment without seepage flow, respectively. Under two snowmelt flow rates, when soil thaw depth increased from 5 cm to 10 cm, hillslope runoff depth and soil erosion amount increased by 10.0% to 13.5% and 15.4% to 37.1% in the treatment without seepage flow, respectively. In the treatment with seepage flow, when soil thaw depth shifted from 5 cm to 10 cm, hillslope runoff depth increased by 6.5% to 8.5%, and soil erosion amount remained stable. Moreover, hillslope rill development was comprehensively influenced by seepage flow, soil thaw depth, and snowmelt flow rate, with rill erosion amount occupying more than 72% of hillslope snowmelt erosion amount. Compared with the treatment without seepage flow, flow velocity and shear stress under the treatment with seepage flow increased by 20.3% to 23.2% and 37.0% to 51.3%, respectively; but Darcy-Weisbach friction coefficient reduced by 9.0% to 21.4%, which caused an increase of hillslope snowmelt erosion. In addition, seepage flow enhanced rill development, which caused rill erosion amount to increase by 43.6% to 69.9% compared with the treatment without seepage flow, and it further resulted in the increase of hillslope snowmelt erosion amount. The main reason for soil thaw depth enhancing hillslope snowmelt erosion amount under the treatment without seepage flow was that both sloping runoff erosivity and erodible materials increased with increasing soil thaw depth. Furthermore, soil thaw depth had a significant impact on hillslope rill morphology development under the treatment with seepage flow. Rill widening process was dominated when soil thaw depth was 5 cm, whereas rill incision process was dominant when soil thaw depth was 10 cm. This study could improve the understanding of hillslope snowmelt erosion mechanism in Chinese Mollisol region and provide theoretical guidance for the development of water erosion model.
