Background: Evidence shows that individuals achieving AHA’s “Life’s Simple 7” cardiovascular health metrics have significantly reduced risk of CVD incidence and mortality. Geographic variation in CVD risk factors has been previously described. We sought to determine whether CV risk as defined by optimal CV health metrics varied geographically among women. Methods: In 2009, Sister to Sister provided free cardiovascular screenings to 9,442 women in 12 cities, including Atlanta, Baltimore, Boston, Chicago, Dallas, Detroit, Jacksonville, Los Angeles, Miami, St. Louis, Tampa, and Washington, DC. Using biometric data collected from screenings supplemented by surveys on CVD risk, we analyzed variance in the “Simple 7” cardiovascular metrics by city. These metrics were defined as being physically active, having normal blood pressure, weight and blood glucose and total cholesterol levels, and eating a healthy diet. We used 6 of these 7 metrics, excluding diet, to assign each city with a risk score. Results: Few cities were at optimal health. On average, cities achieved 3.8 out of 6 cardiovascular metrics. From a regional perspective, Atlanta, Dallas and Detroit were significantly lower, and Boston and St. Louis were significantly higher than the city-wide average (see figure 1). Conclusion: Significant geographic variation exists in proportion of individuals achieving “ideal CV health” as measured by the AHA’s “Life’s Simple 7”. Given this, solutions to improve community based CV risk will need to be tailored by region.
Objectives To evaluate national trends and geographic variation in the availability of home health care from 2002 to 2015 and identify county‐specific characteristics associated with home health care. Design Observational study. Setting All counties in the United States. Participants All Medicare‐certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system. Measurements County‐specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years. Results The study included 15,184 Medicare‐certified home health agencies that served 97% of U.S. ZIP codes. Between 2002–2003 and 2014–2015, the county‐specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter‐quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non‐Hispanic white, non‐Hispanic black, and Hispanic populations were more likely to have higher availability of home health care. Conclusion The availability of home health care increased nationwide during the study period, but there was much geographic variation.
The objective of this study was to determine whether perceived health status of Iraqi immigrants and refugees residing in the United States was related to pre-migration environmental stress, current unemployment, and if they had emigrated before or after the 1991 Gulf War. A random sample of Iraqis residing in Southeast Michigan, US, was interviewed using an Arab language structured survey. The main outcome measure was self-rated health (SRH). Major predictors included socioeconomics, employment status, pre-migration environmental stress, and health disorders. Path analysis was used to look at mediating effects between predictors and SRH. We found that SRH was significantly worse among participants that had left Iraq after the 1991 Gulf War. Unemployment and environmental stress exposure were inversely related to SRH. There was a direct path between Gulf War exposure and poor health. In addition, there were indirect paths mediated through psychosomatic and psychiatric disorders to SRH. Another path went from Gulf War exposure, via environmental stress and somatic health to poor health. Unemployment had a direct path, as well as indirect paths mediated through psychiatric and psychosomatic disorders, to poor self-rated health. In conclusion, these results suggest that pre- as well as post-migration factors, and period of migration, affect health.
Cette these a pour but d’etudier les racinements et les representations de la sociologie comprehensive. L’etude sur le fondement permet de representer tous les elements philosophiques, psychiques, sociologiques et historiques presents dans le monde reel et mental, et qui peuvent nous aider a mener a bien notre etude sociologique. La representation nous pousse a etablir un systeme de pensee sans chercher positivement la causalite et les lois generales. Le sens de la vie, la morale, l’ethique, etc. liees a l’etre humain non seulement peuvent mais doivent etre interpretees par la comprehension sociologique, car elles ne sont pas separees de l’activite humaine dans les phenomenes. Sans confondre avec un aprioriste moral, l’idee vitale determine que dans la recherche sociologique, la vie des hommes est consideree comme la finalite de toutes les activites.
Esophageal squamous cell carcinoma (ESCC) has been listed among the most common esophageal cancers (ECs). Patients are generally relatively old in terms of their age at diagnosis of ESCC. A retrospective, population-based study appraising 537 elderly ESCC patients who suffered distant metastasis (DM) in stage IVB from 2010 to 2016 was performed. To this end, data pertaining to Surveillance, Epidemiology, and End Results (SEER) were adopted.A total of 537 elderly patients with IVB-stage ESCC suffering DM treated from 2010 to 2016 were taken as subjects. Prognosis was determined by using Kaplan-Meier analysis, as well as univariate and multivariate Cox regression. In accordance with sites of metastasis, these patients were classified into five groups: bone-, lung-, brain-, liver-only, and multiple-site (metastases to two or more organs) groups. In order to assess the prognosis, the cancer-specific survival (CSS), median survival time (MST), overall survival (OS), and survival rate (SR) were examined.The lung was found to be the organ most vulnerable to metastasis in the population with single-organ metastasis, and liver, bone and brain followed in descending rank order. Relative to the group only having bone metastasis, the multiple-site group had the lowest CSS (HR: 1.067; 95% CI: 0.767-1.485; P=0.700) and OS (HR: 1.051; 95% CI: 0.759-1.454; P=0.766). The MST (MST: both 2 months in CSS and OS) and SR (6-month SR: 28.2% in CSS, 27.7% in OS; 1-year SR: 7.5% in CSS, 6.7% in OS; 3-year SR: 2.5% in CSS, 1.5% in OS) were also found to be the lowest for the multiple-site group among the total population. These patients benefited from treatment with chemotherapy (C), radiotherapy (R), and surgery (S), as evinced by the prognosis (CSS and OS: P<0.001), in comparisons with untreated patients (N) in the total population. The S or/and R + C resulted in no statistically significant differences to C alone (CSS: P=0.593; OS: P=0.510) in terms of the prognostic results, which indicated that C alone can have almost the same prognostic effect as multimodal therapy.Population-based research was used to determine patterns of metastasis and survival outcomes of elderly patients with IVB-stage ESCC suffering DM. The worst CSS and OS were found in patients with multiple-site metastasis across all groups. The treatment is an independent prognostic factor affecting prognosis. Chemotherapy plays a vital role in prognosis. Active therapies are beneficial to elderly patients with IVB-stage ESCC suffering DM, particularly chemotherapy.
Art very early.This article examines the literary image of Yan'an Literature and Art in the United States as an example, in order to explore the strategy of Chinese literature going global by analyzing the cultural bias
Objective
To study and explore the value of high-frequency ultrasound in the diagnosis and treatment of intussusception in children.
Methods
90 children suspected as intussusception in our hospital from January 2015 to December 2017 were selected. All children underwent high-frequency ultrasound and X-ray examination, and ultrasound and X images were analyzed. The sensitivity, specificity, and accuracy of high-frequency ultrasound and X-ray in the diagnosis of intussusception in children were calculated and compared. The consistency between the results of high-frequency ultrasound and X-ray in the diagnosis of pediatric intussusception and the results of diagnosis were compared. Under the guidance of high frequency ultrasound, children with intussusception was treated with aero-pressor-therapy, and the therapeutic effect was observed.
Results
The sensitivity, specificity, and accuracy of high frequency ultrasound in the diagnosis of pediatric intussusception were 95.65%, 95.24%, 95.56%, the diagnostic sensitivity, accuracy of high frequency ultrasound were higher than those of X-ray (P 0.05). The conformance analysis showed that there was a good consistency between the results of high-frequency ultrasound and the results of diagnosis for pediatric intussusception, while the consistency between X-ray and the results of diagnosis for pediatric intussusception was not good. After aero-pressor-therapy guided by high frequency ultrasound, the success rate of pediatric intussusception reduction was 100%, without case of transfer operation.
Conclusion
High frequency ultrasound can make sensitive and accurate diagnosis for intussusception in children. It has high diagnostic value, can also guide aero-pressor-therapy, which is beneficial to improve the success rate of intussusception reduction.
Key words:
Pediatric intussusception; High frequency ultrasound; Diagnosis; Aero-pressor-therapy
The misuse and abuse of opioids has become a serious public health threat in the United States. The state of California has been hit particularly hard by the opioid epidemic, with a noticeable increase in opioid-related fatalities and hospitalizations. This brief report paper aims to contribute to the growing literature by conducting a geospatial analysis of opioid dispensing patterns in California in 2021. The primary objective was to identify areas characterized by high-risk opioid dispending patterns and explore possible contributing factors. This retrospective study analyzed data from over 7 million records of opioid and benzodiazepine prescriptions dispensed by outpatient pharmacies in California in 2021. A series of generalized linear regression models was employed to assess the impact of neighborhood characteristics on opioid recipients and high-risk opioid dispensing. The study defined high-risk opioid dispensing behavior as: (1) multiple provider episodes, (2) overlapping opioid prescriptions for seven or more days, (3) overlapping opioid and benzodiazepine prescriptions for seven or more days, and (4) a high standardized dosage of opioid prescriptions per month. The study identified variables associated with high-risk opioid dispensing behaviors, including age, population density, income, and housing-related variables, as well as marital status and family-related variables. The study uncovered that there are noticeable disparities in opioid dispensing among different racial and ethnic groups within California. The findings indicated a correlation of high-risk dispensing indicators with certain demographic and socioeconomic factors. There was a substantial regional variation in opioid dispensing practices, with certain rural areas having higher rates of opioid prescriptions than urban areas.
This paper aims to discuss the nursing and safety of silver needle diathermy in the treatment for ankylosing spondylitis. We nursed 46 patients with ankylosing spondylitis treated with silver needle diathermy. Specific nursing was focused on physical condition evaluation and mental nursing before treatment, observation during and after treatment, diet nursing, needle eye nursing, functional training and propaganda and education when discharged. The result suggested that all the patients received mental nursing, diet guide, skin care, health education, functional training and follow-up visit from the nurse and all of them could endure silver needle diathermy as discomfort or drug allergy was barely found, so were slight scald and skin infection nearby the needle eye caused by fainting during acupuncture, accidental puncture or overheat. Follow-up visit showed that no patient suffered obvious untoward effect and the pain, joint range of motion and living condition were distinctly improved a week after discharging. In conclusion, during the treatment for ankylosing spondylitis applying silver needle diathermy, the nursing before, during and after the treatment can obviously reduce the complication, accelerate the recovery, which is highly safe.
'/%3e%3cuse xlink:href='%23a' transform='rotate(144 450 300)'/%3e%3cuse xlink:href='%23a' transform='rotate(216 450 300)'/%3e%3cuse xlink:href='%23a' transform='rotate(288 450 300)'/%3e%3c/svg%3e)
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)