1,721,009 research outputs found
Projecting long-term care costs among older adults with ADL disabilities and cognitive impairment in China
No full textBackground: mounting evidence suggests that cognitive impairment is strongly associated with disability in activities of daily living (ADL disability) and long-term care (LTC) costs. However, studies forecasting future LTC costs often overlook these relationships. Consequently, this study aims to more accurately project future LTC costs in China over the next 20 years by considering the intertwined association between disability and cognitive impairment on future LTC costs. Methods: data were from 10 959 adults ≥65 years from the 2005–2018 waves of the Chinese Longitudinal Healthy Longevity Surveys. We used the Markov model to project the population of China and track the transition of older adults in the next 20 years between 4 disability–cognition states. We employed a 2-part model to estimate LTC costs (direct and indirect LTC costs) per capita.Results: the proportion of disabled older adults with cognitive impairment was projected to increase from 1.4% in 2021 to 3.4% in 2040, while that of those without cognitive impairment was projected to decrease from 4.7% in 2021 to 4.5% in 2040. The direct and indirect LTC costs were projected to increase from 0.3% and 0.2% of gross domestic product (GDP) in 2021 to 1.4% and 0.7% in 2040 for disabled persons without cognitive impairment and from 0.1% and 0.1% of GDP in 2021 to 1.3% and 1.3% in 2040 for those with cognitive impairment, respectively. Conclusions: policy-makers could include the assessment of cognition in the LTC needs assessment and allocate more compensation to LTC insurance participants with cognitive impairment.</p
Association between Home Modification and Falls Among Older Adults: The Health and Retirement Study
No full textAbstractBackground: The aging population is rapidly increasing, and falls are a significant threat to the health and well-being of older adults. Falls are the leading cause of injury among individuals aged 65 and older, resulting in increased healthcare costs, morbidity, and mortality. Preventing falls among older adults requires a multifaceted approach that includes education, training, research, and policy development. While studies have evaluated the effectiveness of multifactorial interventions, little attention has been paid to home modification as a fall prevention strategy. The purpose of this study is to examine the impact of home modification on the incidence of falls and fall-related injuries among retired older adults in the United States who are living independently in the community. Using data from the Health and Retirement Study (HRS), we investigated whether home modification is associated with a lower incidence of falls.
Method: This study utilized data from the Health and Retirement Study (HRS) to investigate the association between home modifications and falls among community-dwelling older adults in the United States. The study included 4,620 participants aged 60 years and older who completed surveys in 2006 and 2008. The primary outcome was the occurrence of falls during the follow-up period in 2008, and the secondary outcome was injury due to a fall. The binary variable for home modification was created based on whether participants reported having any home modifications in the last two years. Covariates included demographic characteristics, lifestyle factors, and health-related variables. Baseline demographic and health characteristics were described using means, standard deviations, counts, and proportions. Two- sample t-tests and chi-squared tests were used to compare continuous and categorical variables
between participants with and without home modifications. Logistic regression models were used to assess the unadjusted and adjusted associations between home modifications and falls, adjusting for various covariates. Interaction analyses were conducted to examine the differences in associations by sex and age.
Result: This study aimed to investigate the association between home modification and falls among older adults. A total of 4,620 participants were included in the study, divided into two groups: those with and without home modification. The incidence of falls in the past two years was similar in both groups, with 25.94% in the home modification group and 25.08% in the non-home modification group. Participants with home modification had 17% lower odds of falls than those without home modification. Additionally, participants with home modification had 22% lower odds of fall-related injuries. The study found that the age category of 60-69 had the lowest incidence of falls, and female participants had a lower incidence of falls than males after home modification. The presence of safety and getting around features in home modifications was also associated with a reduced incidence of falls.
Conclusion: This study suggests that home modification can be an effective strategy to prevent falls and fall-related injuries among older adults living in the community. The findings are consistent with previous research and provide valuable information for healthcare professionals and policymakers to design interventions that include home modification to reduce the burden of falls and their associated injuries in older adults.</p
Oral Health among Children and Adolescents with Disabilities in one Welfare School in Chengdu from 2018 to 2019
No full textBackground: To identify the oral health status of children and adolescent with disabilities in one welfare school in Chengdu. With several disabilities, physical and intellectual deficiency will affect disabled children’s daily life. They pay little attention to their own health status especially oral health. Therefore, this vulnerable group require some concerns. Examining their oral health status is necessary to change their situations of low access to oral health resources and failure of describing their feelings for various reasons, which could help them reduce the rate of having oral diseases. We aim to explore the severity of caries and periodontal status among child with disabilities. Methods: We included 173 disabled children, 92 participants in 2018 and 81 participants in 2019, who were at least three years old and less than 24. They obtained the treatment from West China Stomatological Hospital and participated in an examination of their oral health status. There were four outcomes: caries, gingivitis, dental calculus, and oral health. Although there were three indexes [decayed (dt/DT), missed (mt/MT), and filled (ft/FT) teeth] indicating decayed tooth, we combined three indexes into one (“caries”) to check whether one tooth is healthy or unhealthy. For gingivitis and dental calculus, “yes or no” is the statistical method. Oral health is a new index that represents whether one’s oral health status is healthy. If one person obtains caries or gingivitis or both, it means unhealthy. We used the logistic regression to examine how demographic characteristics (age, sex, household registration, and nationality) were jointly associated with each of the four outcomes (caries, gingivitis, dental calculus, and oral health) separately. Results: Four indexes (caries, gingivitis, dental calculus, and oral health) were created to determine disabled children’s oral health status. Disabled children's mean of caries was 2.77, and they shared a caries prevalence rate of 63%. 31 (17.9%) had one caries and 78 (45.1%) had two or more caries. More than 75% of had obtained fewer than five caries. For caries prevalence, we found a significantly higher prevalence of dental caries among participants aged less than 12 years (87.7%) than those aged at least 12 years (50.9%). After mutually adjustment of socio-demographic characteristics, participants aged at least 12 years had a 86% (95% CI: 65%, 94%) lower odds of having dental caries than those aged less than 12 years. For gingivitis, we found a significantly higher gingivitis detection rate among Han (87.7%) than Qiang (18.8%) and Zang (7.9%). After mutually adjustment of socio-demographic characteristics, Zang had a 81% (95% CI: 17%, 96%) lower odds of having gingivitis than Han. For dental calculus, we found a significantly higher detection rate of dental calculus among males (14.6%) than females (3.9%). After mutually adjustment of socio-demographic characteristics, females had a 376% (95% CI: 22%, 1754%) higher odds of having dental calculus than males. For oral health rate, we found a significantly higher oral health rate among participants aged at least 12 years (38.8%) than those aged less than 12 years (10.5%). After mutually adjustment of socio-demographic characteristics, participants aged at least 12 years had a 82% (95% CI: 65%, 94%) lower odds of having good oral health than those under 12 years.Conclusions: We presented disabled children’s oral health status in three oral health criteria: caries status, periodontal health status (gingivitis and dental calculus), and general oral health status. The comprehensive oral health status of disabled children shared a high mean of caries and a high prevalence rate. Their periodontal health status was better than the Fourth National oral Health Epidemiological Survey criteria. The comprehensive oral health rate was poor. Therefore, additional studies are necessary to make improvements to it.</p
Accuracy of Smartphone Application Screening for Obstructive Sleep Apnea in Adults
No full textBackground: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a common sleep disorder that affects millions of adults worldwide, with higher prevalence reported in Asia compared to Western countries. If left untreated, OSAHS can lead to serious health complications such as high blood pressure, heart disease, stroke, and diabetes. While polysomnography (PSG) is considered the gold standard of sleep testing, it may not be suitable for all OSAHS patients due to its cost and invasiveness. In recent years, the development of mobile applications has provided a convenient and accessible tool for screening and diagnosis of OSAHS. This study aimed to evaluate the efficacy of the Dr. Being app, a snoring analysis software for smartphones, in screening Chinese adults for OSAHS. The findings of this study will provide insights into the potential of mobile health technologies in improving the detection and management of OSAHS in China.Methods: In this prospective study conducted between December 2021 to December 2022, 50 patients were recruited from the sleep center of Shanghai Sixth People's Hospital. The study participants had a mean age of 49.7±17.4 years, with a male predominance of 70%, and a mean body mass index of 28.2±5.0 kg/m². Each participant underwent monitoring throughout the night using both the Dr. Being app and polysomnography (PSG). The Dr. Being app's automatic analysis generated relevant indicators, which were then compared with the results obtained from PSG interpreted by sleep professionals according to recommended guidelines. The study aimed to evaluate the concordance between the apnea-hypopnea index (AHI) obtained by the Dr. Being app and PSG results. Furthermore, the researchers assessed the sensitivity and specificity of the Dr. Being app in diagnosing OSAHS, which could provide valuable insights into the effectiveness of smartphone apps in sleep testing.
Results: This study's findings suggest that there were significant differences between the total sleep time (TST) and apnea-hypopnea index (AHI) measured by the Dr. Being app and PSG. Specifically, the TST measured by the Dr. Being app was found to be significantly higher than PSG, while PSG had a slightly higher AHI measurement than the Dr. Being app. Despite these differences, the Bland-Altman consistency test showed that the AHI measurements obtained from both methods were statistically consistent, indicating that the Dr. Being app can provide accurate measurements of AHI, which is a crucial indicator of OSAHS severity. Furthermore, the study assessed the sensitivity and specificity of the Dr. Being app in diagnosing OSAHS at different AHI thresholds. The results indicated that the app had high sensitivity and specificity for OSAHS diagnosis at an AHI threshold of 5/h and moderate sensitivity and specificity at an AHI threshold of 15/h. However, the sensitivity decreased while the specificity increased as the AHI threshold increased to 30/h. Overall, these findings suggest that the Dr. Being app could be a valuable tool for OSAHS screening and diagnosis, particularly in resource-limited areas.
Conclusion: These findings highlight the usefulness of the Dr. Being app in the screening and diagnosis of OSAHS, particularly in resource-limited areas where access to PSG may be limited. The app's high sensitivity in detecting early OSAHS index indicates its potential as a valuable tool for both clinicians and patients. With its ability to provide accurate measurements of mild AHI, the Dr. Being app could aid in the early detection of this condition. Overall, the Dr. Being app could serve as a valuable supplement to traditional sleep testing methods, potentially improving the accessibility and affordability of OSAHS diagnosis and management.
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Projecting long-term care costs for home and community-based services in China from 2005 to 2050
No full textObjectives: the aim of this study was to estimate and project the trend in long-term care (LTC) costs for home and community-based services as a percentage of gross domestic product in China between 2005 and 2050.Design: longitudinal.Setting and participants: we used 61,249 observations from 37,702 adults age ≥65 years from waves 2005, 2008, 2011, 2014, and 2018 of the Chinese Longitudinal Healthy Longevity Surveys.Methods: LTC costs for home and community-based services consisted of the monetary value of time spent on LTC and the direct LTC cost. We used the age-sex-residence-specific weights provided by the Chinese Longitudinal Healthy Longevity Surveys to estimate the LTC costs from 2005 to 2018. We used a component-based model to project LTC costs, in which the 2-part model was used to estimate the average LTC costs and the multi-state Markov model approach was used to project the future population by age, sex, and disability state.Results: the percentage of older adults with disabilities was projected to increase from 6.1% in 2005 to 7.5% in 2020 and 9.6% in 2050. The total LTC cost for home and community-based services were projected to increase from 0.3% of gross domestic product in 2005 to 0.7% in 2020 and to 6.4% in 2050.Conclusions and implications: policymakers in China should take urgent actions to delay the onset of disabilities among older adults, which would curb the increasing LTC costs and maintain the sustainability of the LTC policies
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Quantitative Analysis of Polycyclic Aromatic Hydrocarbons in Heated Soybean Oil
No full textPolycyclic aromatic hydrocarbons (PAHs) are compounds ubiquitous in the environment and are harmful to human health. PAHs can easily enter the human body through the consumption of edible oils due to their high lipophilicity. Most of the published papers investigating PAH concentrations in edible oils focused on virgin (i.e., unheated) samples instead of those being used in cooking at temperatures higher than room temperature. This study aimed to provide a comprehensive landscape of PAH concentration in soybean oil by simulating a more realistic scenario of oil consumption—eating oil being cooked at different temperatures. I quantified the concentration of PAHs in soybean oil after being heated to four temperatures (100°C, 150°C, 190°C, and 222°C) with three durations (5 minutes, 30 minutes, and 60 minutes). Liquid liquid extraction (LLE), tandemly followed by solid phase extraction (SPE), were used to extract PAHs from the matrix and remove interferences from the extract. PAH concentrations were determined by a gas chromatography mass spectrometer (GC-MS). With extended heating time, concentrations of ACE and FLU showed a rising trend in 100°C and 150°C data groups but a falling trend at higher temperature data groups. Concentrations of PHEN and ANTH had a sharp increase when the oil was heated to 222°C and held one hour. Concentrations of B[a]A, CHRY, and B[a]P rose slightly with extended heating time at almost all temperatures. Concentrations of ACY, FLTH, B[b]F, B[k]F, IND, D[ah]A, and B[ghi]P were low and nearly undetectable. Only NAP concentrations in 100°C-oil samples were over the maximum residue level (MRL) set by China’s national standard. Diverse concentration changes of different PAHs after the oil was heated suggested that B[a]P alone or a combination of several PAHs are not sufficiently representative to be the marker or surrogate for PAH exposure. This diversity also resulted in an undetermined correlation between the PAH remaining in the oil and heating temperatures and hold time. The information of PAHs increment caused by heating soybean oil was incomplete because of data unavailability for the vaporized part.</p
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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