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1.
BMC Health Serv Res ; 22(1): 424, 2022 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-35361211

RESUMO

BACKGROUND: The "4 + 7" volume-based procurement is a "large group purchase" led by the Chinese government, with the aim of reducing the price of medicines by trading volume for price. Although the "4 + 7" drugs had passed the national consistency evaluation, the adverse drug reactions need to be further evaluated to ensure the safety of the "4 + 7" drugs with low prices. We aimed to analyze the occurrence characteristics and related influencing factors of adverse reactions of psychiatric drugs under the chinese drug volume-based procurement policy(4 + 7 policy), and provide references for clinical medication. METHODS: 137 cases of adverse drug reactions of four psychotropic drugs reported under the "4 + 7" policy in Wuxi Mental Health Center in 2020 were collected. The gender and age of patients, related "4 + 7" drugs, involving organs / systems, clinical manifestations, distribution of new / serious adverse reactions, clinic outcomes were analyzed. RESULTS: Among the 137 cases of adverse drug reactions, the incidence of adverse drug reactions was the highest in patients aged 61-70 (25.38%). Mainly involved 4 "4 + 7" psychiatric drugs, of which olanzapine tablets caused the most adverse reactions (54, 39.24%). The adverse reactions mainly involved the digestive system, nervous system, cardiovascular system, blood and lymphatic system, among which the digestive system was the most common (61, 44.53%). A total of 8 cases (6.16%) of new and 26 cases of serious adverse reactions were reported, all of which led to the prolongation of disease course. Except for the transient side effects, most of that were improved or cured with no death, disability or teratogenicity after stopping or reducing the dose with symptomatic treatment. CONCLUSION: Since more and more drugs will be included in "4 + 7" for clinic, clinical pharmacists should strengthen the publicity and training of the knowledge of "4 + 7" drugs, strengthen the monitoring of adverse drug reactions, and provide timely feedback to the clinic, in order to achieve early prevention, early identification, timely diagnosis and reasonable intervention of the adverse drug reactions under the context of "4 + 7" policy.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Idoso , China/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Humanos , Incidência , Pessoa de Meia-Idade , Psicotrópicos/efeitos adversos , Política Pública
2.
Eur J Neurol ; 29(4): 1017-1024, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34951095

RESUMO

BACKGROUND AND PURPOSE: Variants in the glucocerebrosidase (GBA) gene are recognized as a common and important genetic risk factor for Parkinson disease (PD). However, the impact of variant severity on the clinical phenotype of PD in the Chinese population remains unclear. Thus, the present study aimed to determine the frequency of GBA-related PD (GBA-PD) and the relationship of GBA variant severity with clinical characteristics in a large Chinese cohort. METHODS: Long-range polymerase chain reaction and next generation sequencing were performed for the entire GBA gene. GBA variant severity was classified into five classes: mild, severe, risk, complex, and unknown. RESULTS: Among the total 737 PD patients, 47 GBA variants were detected in 79 (10.72%) patients, and the most common GBA variants were R163Q, L444P, and R120W. Complete demographic and clinical data were obtained for 673 patients, which revealed that 18.50% of early onset PD patients had GBA variants. Compared with patients without GBA variants, GBA-PD patients experienced PD onset an average of 4 years earlier and had more severe motor and nonmotor symptoms. Patients carrying severe and complex variants had a higher burden of nonmotor symptoms, especially depression, and more mood/cognitive and gastrointestinal symptoms than patients carrying mild variants. CONCLUSIONS: GBA-PD is highly prevalent in the Chinese population. The severity of GBA variants underlies distinct phenotypic spectrums, with PD patients carrying severe and complex variants seeming to have similar phenotypes. PD patient stratification by GBA variant severity should become a prerequisite for selecting specific treatments.


Assuntos
Glucosilceramidase , Doença de Parkinson , China/epidemiologia , Estudos de Associação Genética , Predisposição Genética para Doença , Glucosilceramidase/genética , Humanos , Mutação/genética , Doença de Parkinson/epidemiologia , Doença de Parkinson/genética , Doença de Parkinson/psicologia , Prevalência
3.
Artigo em Inglês | MEDLINE | ID: mdl-35682485

RESUMO

AIM: To explore associations between sleep duration and physical fitness (PF) of children aged 3-6 years. METHODS: This study investigated the sleep duration and PF data of children aged 3-6 years by stratified random sampling. The restricted cubic spline model and binary logistic regression analysis were mainly used for the empirical analysis of the correlation effect between sleep duration and PF. The final data had a total of 21,857 children, of which 11,245 (51.45%) were boys and 10,612 (48.55%) were girls. RESULTS: The PF level of the children in this study showed a relatively positive level (pass rate = 93.6%), and 19.7% of them had abnormal sleep duration; the results of the restricted cubic spline showed an inverted U-shaped association between the level of PF and the risk of abnormal sleep duration (X2 = 28.13, p < 0.0001). The results of logistic regression analysis showed that children with abnormal sleep duration were more likely to have a low PF, body morphology and motor ability levels at an OR (95% CI) of 1.077 (1.023-1.133), 1.077 (1.016-1.142) and 1.035 (1.08-1.062), respectively. The results of the bias correlation analysis showed varying degrees of correlation between sleep duration and various components of children's PF. CONCLUSION: Insufficient or excessive amounts of sleep were significantly associated with PF in children, with abnormal sleep duration leading to reduced levels of PF and its components.


Assuntos
Aptidão Física , Sono , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino
4.
Artigo em Inglês | MEDLINE | ID: mdl-35682487

RESUMO

Exposure to indoor air pollution from cooking with solid fuel has been linked with the health of elderly people, although the pathway to their association is unclear. This study aimed to investigate the mediating effects between solid fuel use and self-rated health by using structural equation modeling (SEM) with the baseline data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). We conducted a cross-sectional survey among 7831 elderly people aged >65 years from the CLHLS. SEM was used to analyze the pathways underlying solid fuel use and self-rated health. We estimated indirect effects of sleep quality (ß = -0.027, SE = 0.006), cognitive abilities (ß = -0.006, SE = 0.002), depressive symptoms (ß = -0.066, SE = 0.007), systolic blood pressure (ß = 0.000, SE = 0.000), and BMI (ß = -0.000, SE = 0.000) on the association between solid fuel and the self-rated health using path analysis. Depressive symptoms emerged as the strongest mediator in the relationship between solid fuel use and self-rated health in the elderly. Interventions targeting sleep quality, cognitive abilities, depressive symptoms, systolic blood pressure, and BMI could greatly reduce the negative effects of solid fuel use on the health of the elderly population.


Assuntos
Poluição do Ar em Ambientes Fechados , Análise de Mediação , Adulto , Idoso , Poluição do Ar em Ambientes Fechados/análise , China/epidemiologia , Culinária , Estudos Transversais , Humanos , Análise de Classes Latentes
5.
Sci Total Environ ; 838(Pt 3): 156272, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35644395

RESUMO

BACKGROUND: As a communicable disease and major public health issue, many studies have quantified the associations between tuberculosis (TB) and meteorological factors with inconsistent results. The purpose of this multicenter study was to characterize the associations between ambient temperature, humidity and the risk of TB hospitalizations and to investigate potential heterogeneity. METHOD: Data on daily hospitalizations for TB, meteorological factors and ambient air pollutants for 16 cities in Anhui Province were collected from 2015 to 2020. A distributed lag nonlinear model (DLNM) was performed to obtain the estimates of meteorological-TB relationships by cities. Then, we used the multivariate meta-regression model to pool the city-specific estimates with air pollution, demographic indicators, medical resource and latitude as potential modifiers to explore the sources of heterogeneity. Finally, we divided the whole province into three regions to validate the meteorological-TB relationships by regions. RESULTS: The overall pooled temperature-TB association presented an approximate S-shaped curve, with relative risk (RR) peaking at 5 °C (RR = 1.536, 95% CI: 1.303-1.811) compared to the reference temperature (27 °C). Lag-response curve suggested that low temperature exposure increased the risk of TB hospitalizations at lag 0 and 1 day (lag0 day: RR = 1.136, 95% CI: 1.048-1.231, lag1 day: RR = 1.052, 95% CI: 1.023-1.082). However, the overall exposure-response curve between relative humidity and TB showed almost horizontal line with reference relative humidity to 78%. The residual heterogeneity ranged from 27.1% to 36.9%, with air pollution, latitude and medical resource explained the largest proportion. CONCLUSION: We found that low temperature exposure is associated with an acute increased risk of TB hospitalizations in Anhui Province. The association between temperature and TB admission varies depending on air pollution, latitude, and medical resources. Since the effect of short-term exposure to humidity is not significant, further studies are supposed to focus on the long-term effect of humidity.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Tuberculose , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China/epidemiologia , Hospitalização , Humanos , Umidade , Temperatura , Tuberculose/epidemiologia
6.
Sci Total Environ ; 838(Pt 3): 156425, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35660600

RESUMO

BACKGROUND: Composite temperature-related indices have been utilized to comprehensively reflect the impact of multiple meteorological factors on health. We aimed to evaluate the predictive ability of temperature-related indices, choose the best predictor of stroke morbidity, and explore the association between them. METHODS: We built distributed lag nonlinear models to estimate the associations between temperature-related indices and stroke morbidity and then applied two types of cross-validation (CV) methods to choose the best predictor. The effects of this index on overall stroke, intracerebral hemorrhage (ICH), and ischemic stroke (IS) morbidity were explored and we explained how this index worked using heatmaps. Stratified analyses were conducted to identify vulnerable populations. RESULTS: Among 12 temperature-related indices, the alternative temperature-humidity index (THIa) had the best overall performance in terms of root mean square error when combining the results from two CVs. With the median value of THIa (25.70 °C) as the reference, the relative risks (RRs) of low THIa (10th percentile) reached a maximum at lag 0-10, with RRs of 1.20 (95%CI:1.10-1.31), 1.49 (95%CI:1.29-1.73) and 1.12 (95%CI:1.03-1.23) for total stroke, ICH and IS, respectively. According to the THIa formula, we matched the effects of THIa on stroke under various combinations of temperature and relative humidity. We found that, although the low temperature (<20 °C) had the greatest adverse effect, the modification effect of humidity on it was not evident. In contrast, lower humidity could reverse the protective effect of temperature into a harmful effect at the moderate-high temperature (24 °C-27 °C). Stratification analyses showed that the female was more vulnerable to low THIa in IS. CONCLUSIONS: THIa is the best temperature-related predictor of stroke morbidity. In addition to the most dangerous cold weather, the government should pay more attention to days with moderate-high temperature and low humidity, which have been overlooked in the past.


Assuntos
Acidente Vascular Cerebral , China/epidemiologia , Feminino , Humanos , Umidade , Morbidade , Acidente Vascular Cerebral/epidemiologia , Temperatura
7.
Hist Cienc Saude Manguinhos ; 29(2): 381-398, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35674618

RESUMO

The coronavirus pandemic has exposed a global tendency throughout history to blame immigrants for propagating epidemics. Chinese individuals were thus targeted during past public health crises in Peru, but during the current coronavirus pandemic racist notions painting people of Chinese descent as "agents of contagion" diminished significantly. Here we examine three major epidemics (yellow fever, the bubonic plague, and covid-19) to demonstrate the current and somewhat surprising shift in negative attitudes toward the Chinese community. Peruvians' refusal to embrace derogatory terms (the "Chinese virus") or target individuals of Asian descent constitutes an intriguing case at a moment when xenophobic discourse is rampant in the Western hemisphere.


Assuntos
COVID-19 , Racismo , COVID-19/epidemiologia , China/epidemiologia , Migração Humana , Humanos , Pandemias , Peru/epidemiologia
8.
Sci Total Environ ; 839: 156299, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-35643130

RESUMO

BACKGROUND: Previous studies have separately linked either perfluoroalkyl acid (PFAA) or heavy metal exposure with kidney dysfunction. However, the relationships of co-exposure to PFAAs and heavy metals with kidney function are still unclear. OBJECTIVES: To explore the associations between exposure to PFAAs and heavy metals mixtures and kidney function in adults. METHODS: We conducted a cross-sectional community-based population study in Guangzhou, China, enrolling 1312 adults from November 2018 to August 2019. We quantified 13 PFAAs in serum and 14 heavy metals in plasma. We chose estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) as outcomes of interest. Distributed lag non-linear models (DLNMs) were used to check nonlinearity of individual pollutant with kidney function. Joint associations of pollutant mixtures on kidney function were assessed by Bayesian Kernel Machine Regression (BKMR) models. We further explored modification effects of gender. RESULTS: Most individual PFAA and heavy metal were associated with declined kidney function in single-pollutant models. We also observed significant dose-response relationships of pollutant mixtures with reduced eGFR levels and increased odds of CKD in BKMR models. Perfluoroheptanesulfonic acid (PFHpS), arsenic (As) and strontium (Sr) were the predominant contributors among pollutant mixtures. A change in log PFHpS, As and Sr concentrations from the 25th to the 75th percentile were associated with a decrease in eGFR of -5.42 (95% confidence interval (CI): -6.86, -3.98), -2.14 (95% CI: -3.70, -0.58) and -1.87 (95% CI: -3.03, -0.72) mL/min/1.73 m2, respectively, when other pollutants were at their median values. In addition, the observed associations were more obvious in females. CONCLUSIONS: We provided new evidence that co-exposure to PFAAs and heavy metals mixtures was associated with reduced kidney function in adults and PFHpS, As and Sr appeared to be the major contributors. Further studies are warranted to confirm our findings and elucidate the underlying mechanisms.


Assuntos
Arsênio , Poluentes Ambientais , Fluorcarbonetos , Metais Pesados , Insuficiência Renal Crônica , Adulto , Teorema de Bayes , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Rim , Insuficiência Renal Crônica/induzido quimicamente , Insuficiência Renal Crônica/epidemiologia , Estrôncio
9.
Antimicrob Agents Chemother ; 66(6): e0238321, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35652645

RESUMO

Invasive meningococcal disease (IMD) due to serogroup Y Neisseria meningitidis (NmY) is rare in China; recently, an invasive NmY isolate, Nm512, was discovered in Shanghai with decreased susceptibility to penicillin (PenNS). Here, we investigated the epidemiology of NmY isolates in Shanghai and explored the potential commensal Neisseria lactamica donor of the PenNS NmY isolate. A total of 491 N. meningitidis and 724 commensal Neisseria spp. isolates were collected. Eleven NmY isolates were discovered from IMD (n = 1) and carriers (n = 10), including two PenNS isolates with five-key-mutation-harboring (F504L-A510V-I515V-H541N-I566V) penA genes. Five of the eight ST-175 complex (CC175) isolates had a genotype [Y:P1.5-1,2-2:F5-8:ST-175(CC175)] identical to that of the predominant invasive clone found in South Africa. Only one invasive NmY CC23 isolate (Nm512) was discovered; this isolate carried a novel PenNS penA832 allele, which was identified in commensal N. lactamica isolates locally. Recombination analysis and transformation of the penA allele highlighted that N. meningitidis Nm512 may acquire resistance from its commensal donor; this was supported by the similar distribution of transformation-required DNA uptake sequence variants and the highly cognate receptor ComP between N. meningitidis and N. lactamica. In 2,309 NmY CC23 genomes from the PubMLST database, isolates with key-mutation-harboring penA genes comprised 12% and have been increasing since the 1990s, accompanied by recruitment of the blaROB-1 and/or quinolone resistance allele. Moreover, penA22 was predominant among genomes without key mutations in penA. These results strongly suggest that Nm512 is a descendant of the penA22-harboring CC23 isolate from Europe and acquired its penicillin resistance locally from commensal N. lactamica species by natural transformation.


Assuntos
Infecções Meningocócicas , Neisseria lactamica , Neisseria meningitidis , China/epidemiologia , Humanos , Neisseria lactamica/genética , Neisseria meningitidis/genética , Neisseria meningitidis Sorogrupo Y , Resistência às Penicilinas/genética , Sorogrupo
12.
BMC Oral Health ; 22(1): 215, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641983

RESUMO

BACKGROUND: The aim of this study was to assess the income-related inequality of edentulism among the aged in China and identify the contributing factors. METHODS: A secondary analysis of data from the 4th National Oral Health Epidemiology Survey in China was conducted, and 65-74 years old were selected for the analysis of income-related inequality of edentulism. The concentration curve, Concentration index (CI) and Erreygers-corrected concentration index (EI) were used to represent inequality and its degree qualitatively and quantitatively, respectively. A decomposition method based on probit model was employed to determine the contributors of inequality, including demographic factors, income status, oral health-related knowledge, attitude and practices and self-perceived general health status. RESULTS: In China, aged people with edentulism were concentrated in the poor. The CI was - 0.2337 (95% CIs: - 0.3503, - 0.1170). The EI was - 0.0413 (95% CIs: - 0.0619, - 0.0207). The decomposition results showed that income (75.02%) and oral health-related knowledge, attitude and practices (15.52%) were the main contributors to the inequality. CONCLUSION: This study showed that pro-poor inequality among the elderly with edentulism existed in China. Corresponding policies against the contributors could be considered to promote the health equality of the elders.


Assuntos
Nível de Saúde , Renda , Idoso , China/epidemiologia , Serviços de Saúde , Humanos , Fatores Socioeconômicos
13.
Open Heart ; 9(1)2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35649571

RESUMO

OBJECTIVES: To compare the shape and strength of the associations of resting heart rate (RHR) with incident heart failure (HF) and pulmonary heart disease (PHD) in Chinese adults. METHODS: The prospective China Kadoorie Biobank recruited >0.5 million adults from 10 geographically diverse regions (5 urban, 5 rural) of China during 2004-2008. After an 11-year follow-up, 6082 incident cases of HF and 5572 cases of PHD, were recorded among 491 785 participants with no prior history of heart disease or use of beta-blockers at baseline. Cox regression yielded HRs for each disease associated with usual RHR after adjustment for confounding factors. RESULTS: The mean (SD) baseline RHR was 79 (12) (men 78 (12); women 80 (11)) bpm, and these decreased with increasing age (by about 1 bpm per 10 years). Usual RHR showed J-shaped associations with HF and log-linear associations PHD. For HF, each 10 bpm higher usual RHR was associated with an adjusted HR of 1.25 (95% CI 1.17 to 1.34) for RHR>75 bpm. For PHD, each 10 bpm higher RHR was associated with HR of 1.74 (1.67-1.81) across the full range of usual RHR. For HF at RHR>75 bpm but not PHD, the HRs per 10 bpm higher RHR were approximately halved by further adjustment for diabetes and hypertension. CONCLUSIONS: RHR was strongly positively associated with PHD throughout the range studied, but was only associated with HF at RHR>75 bpm, and the strength of the associations with HF were only one-third of those with PHD.


Assuntos
Diabetes Mellitus , Insuficiência Cardíaca , Adulto , Criança , China/epidemiologia , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Frequência Cardíaca , Humanos , Masculino , Estudos Prospectivos
14.
Front Public Health ; 10: 878610, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35669754

RESUMO

Background: Hypertension is rising as a major public health burden around the world. This study explored the association between single-nucleotide polymorphisms (SNPs) in the adenosine triphosphate (ATP)-Binding Cassette Subfamily A1 (ABCA1) gene and hypertension among Chinese Han adults. Method: A total of 2,296 Han Chinese in southeast China were recruited for this study. We collected medical reports, lifestyle details, and blood samples from individuals. The polymerase chain reaction-ligase detection reaction (PCR-LDR) method was used to detect the genotypes of these SNPs in the ABCA1 gene. Results: After adjusting some covariates, the additive and recessive models of the rs2472510 and rs2515614 were significantly associated with hypertension. The haplotypes TCTA (rs2297406-rs2472433-rs2472510-rs2515614) were associated with high SBP, and the haplotypes CCTA, TCTA, and TTTA were associated with high diastolic blood pressure (DBP). Conclusion: The results of the relationship between the polymorphisms of rs2297406, rs2472433, rs2472510, and rs2515614 in ABCA1 and hypertension in southeastern China would provide a theoretical basis for genetic screening and disease prevention.


Assuntos
Hipertensão , Transportador 1 de Cassete de Ligação de ATP/genética , Adulto , China/epidemiologia , Genótipo , Humanos , Hipertensão/epidemiologia , Hipertensão/genética , Polimorfismo de Nucleotídeo Único
15.
BMC Geriatr ; 22(1): 492, 2022 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-35676628

RESUMO

BACKGROUND: Inappropriate prescribing of medications and polypharmacy among older adults are associated with a wide range of adverse outcomes. It is critical to understand the attitudes towards deprescribing-reducing the use of potentially inappropriate medications (PIMs)-among this vulnerable group. Such information is particularly lacking in low - and middle-income countries. METHODS: In this study, we examined Chinese community-dwelling older adults' attitudes to deprescribing as well as individual-level correlates. Through the community-based health examination platform, we performed a cross-sectional study by personally interviews using the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire (version for older adults) in two communities located in Suzhou, China. We recruited participants who were at least 65 years and had at least one chronic condition and one prescribed medication. RESULTS: We included 1,897 participants in the present study; the mean age was 73.8 years (SD = 6.2 years) and 1,023 (53.9%) were women. Most of older adults had one chronic disease (n = 1,364 [71.9%]) and took 1-2 regular drugs (n = 1,483 [78.2%]). Half of the participants (n = 947, 50%) indicated that they would be willing to stop taking one or more of their medicines if their doctor said it was possible, and 924 (48.7%) older adults wanted to cut down on the number of medications they were taking. We did not find individual level characteristics to be correlated to attitudes to deprescribing. CONCLUSIONS: The proportions of participants' willingness to deprescribing were much lower than what prior investigations among western populations reported. It is important to identify the factors that influence deprescribing and develop a patient-centered and practical deprescribing guideline that is suitable for Chinese older adults.


Assuntos
Desprescrições , Idoso , Atitude , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Polimedicação
16.
BMC Geriatr ; 22(1): 494, 2022 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-35676655

RESUMO

BACKGROUND: Childhood experience has been suggested to affect cognitive function in later life. However, the association between childhood friendship status and cognitive ageing trajectory in middle-aged and older adults has not been fully assessed. This study examined the association between childhood friendship status and cognitive ageing trajectory and identified factors modifying this association. METHODS: We used four waves of data from the China Health and Retirement Longitudinal Study (CHARLS), a national representative longitudinal study of adults aged 45 years or older, 2011-2018. The CHARLS included surveys on childhood friendship and cognitive assessments. Childhood friendship status was categorised as poor, fair, and good. To examine the association between childhood friendship and cognitive ageing trajectory in later life, we applied multilevel linear regression models, and explored potential influences of sociodemographic factors, health status and behaviours, and childhood conditions on this association. RESULTS: Of the 4,350 participants, 1,919 (44.1%) were women. The mean age was 56.29 ± 7.80 years. We found childhood friendship was significantly associated with cognitive ageing trajectory in later life, with a dose-response relationship. After adjusting for covariates, comparing to participants with poor childhood friendships, those with better childhood friendships had lower rates of cognitive decline (ß = 0.12, 95% confidence interval [CI]: 0.03 to 0.22 [interaction term of fair friendship and time]; ß = 0.19, 95% CI: 0.10 to 0.28 [interaction term of good friendship and time]) and higher level of cognitive functions (ß = 0.40, 95% CI: 0.22 to 0.58 [fair friendships]; ß = 0.61, 95% CI: 0.43 to 0.79 [good friendships]). These associations were stronger for those who were female, less educated, and had experienced more adverse childhood experiences. CONCLUSIONS: Childhood friendship is associated with cognitive ageing in later life. Enhancing childhood friendships can play an important role to promote healthy ageing in the future.


Assuntos
Disfunção Cognitiva , Aposentadoria , Idoso , China/epidemiologia , Cognição/fisiologia , Feminino , Amigos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Aposentadoria/psicologia
17.
PLoS Negl Trop Dis ; 16(6): e0010405, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35679319

RESUMO

BACKGROUND: Hookworm disease is endemic in China and is widespread globally. The disease burden to humans is great. METHODS: The study described the national surveillance of hookworm implemented in 31 provinces/autonomous regions/municipalities (P/A/Ms) of China in 2019. Each P/A/M determined the number and location of surveillance spots (counties). A unified sampling method was employed, and at least 1000 subjects were investigated in each surveillance spot. The modified Kato-Katz thick smear method was employed for stool examination. Fifty samples positive with hookworm eggs were cultured in each surveillance spot to discriminate species between A. duodenale and N. americanus. Twenty-five soil samples were collected from each surveillance spot and examined for hookworm larva. The 2019 surveillance results were analyzed and compared with that of 2016-2018. RESULTS: A total of 424766 subjects were investigated in 31 P/A/Ms of China in 2019, and the overall hookworm infection rate was 0.85% (3580/424766). The weighted infection and standard infection rates were 0.66% (4288357/648063870) and 0.67% (4343844/648063870), respectively. Sichuan province had the highest standard infection rate (4.75%) in 2019, followed by Chongqing (2.54%) and Hainan (2.44%). The standard infection rates of other P/A/Ms were all below 1%, with no hookworm detected in 15 P/A/Ms. The standard hookworm infection rate in the males and the females were 0.61% (2021216/330728900) and 0.71% (2267141/317334970), respectively, with a significant difference between different genders ([Formula: see text] = 17.23, P<0.0001). The highest standard hookworm infection rate (1.97%) was among age ≥ 60 years, followed by 45~59 years (0.77%), 15~44 years (0.37%), and 7~14 years (0.20%). The lowest standard infection rate was among the 0~6 years age group (0.12%). A significant difference was observed among different age groups ([Formula: see text] = 2 305.17, P<0.0001). The constitute ratio for N. americanus, A. duodenale, and coinfection was 78.70% (1341/1704), 2.03% (346/1704), and 1.00% (17/1704), respectively. The detection rate of hookworm larva from soil was 3.45% (71/2056). CONCLUSION: The national surveillance showed that the hookworm infection rate has been decreasing annually from 2016 to 2019, and it is now below 1%. China has made significant progress in controlling hookworm. The national surveillance system is an important way to understand the endemic status and provide important information in this process and thus needs to be continually optimized.


Assuntos
Infecções por Uncinaria , Ancylostomatoidea , Animais , China/epidemiologia , Fezes , Feminino , Infecções por Uncinaria/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Solo
18.
BMC Geriatr ; 22(1): 497, 2022 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-35681136

RESUMO

BACKGROUND: General practitioners (GPs) play a critical role in community detection and management of mild cognitive impairment (MCI). Although adequate knowledge is essential, healthcare practice is shaped by intrinsic and extrinsic factors. This study aimed to test the mediating effect of perceived extrinsic barriers on the associations between knowledge, attitudes, and intended practice of GPs in community detection and management of MCI. METHODS: A cross-sectional study was conducted through an online survey of 1253 GPs sampled from 56 community health centres (CHCs) in Shanghai in 2021. Perceived extrinsic barriers were rated on a five-point Likert scale for patient engagement, working environment, and system context, respectively. A summed score was generated subsequently for each domain ranging from 0 to 100, with a higher score indicating higher barriers. The mediating effect of perceived extrinsic barriers (second-order) and the moderation effect of training on the association between MCI knowledge and practice scores, as well as the moderation effect of past experience on the association between MCI knowledge and extrinsic barriers, were tested through structural equation modelling (SEM) with a partial least square (PLS) approach. RESULTS: The study participants reported an average barrier score of 65.23 (SD = 13.98), 58.34 (SD = 16.95), and 60.37 (SD = 16.99) for patient engagement, working environment, and system context, respectively. Although knowledge had both direct and indirect (through attitudes) effects on intended practice, perceived extrinsic barriers negatively mediated (ß = - 0.012, p = 0.025) the association between knowledge and practice. Training moderated the effect of knowledge on practice (ß = - 0.066, p = 0.014). CONCLUSIONS: Perceived extrinsic barriers have a detrimental effect on the translation of knowledge into practice for community detection and management of MCI. The effect of training on practice declines when knowledge scores become higher.


Assuntos
Disfunção Cognitiva , Clínicos Gerais , China/epidemiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/terapia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Inquéritos e Questionários
19.
Geospat Health ; 17(s1)2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35686992

RESUMO

This study aimed at detecting space-time clusters of COVID-19 cases in Fars Province, Iran and at investigating their potential association with meteorological factors, such as temperature, precipitation and wind velocity. Time-series data including 53,554 infected people recorded in 26 cities from 18 February to 30 September 2020 together with 5876 meteorological records were subjected to the analysis. Applying a significance level of P<0.05, the analysis of space-time distribution of COVID-19 resulted in nine significant outbreaks within the study period. The most likely cluster occurred from 27 March to 13 July 2020 and contained 11% of the total cases with eight additional, secondary clusters. We found that the COVID-19 incidence rate was affected by high temperature (OR=1.64; 95% CI: 1.44-1.87), while precipitation and wind velocity had less effect (OR=0.84; 95% CI: 0.75-0.89 and OR=0.27; 95% CI: 0.14-0.51), respectively.


Assuntos
COVID-19 , COVID-19/epidemiologia , China/epidemiologia , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Conceitos Meteorológicos , Fatores de Risco
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