Objective To analyze the mental health status and its influencing factors in the elderly living in Xi'an communities,so as to bring forth countermeasures to improve their mental health.Methods Convenience sampling was used to select 310 residents aged 60 years or above from 2 communities in Xi'an,and the subjects were surveyed by a self-designed questionnaire.The survey included social demographic characteristics,social support,disability,chronicdisease costs,physical exercises,mental health problems and the coping methods.Univariate chi-square test and multivariable logistic regression were used to identify factors associated with mental health of the elderly.Results Questionnaires with uncompleted answers or suspected unreal answers were excluded.Totally 304 effective questionnaires were collected,with the effective rate being 98.1%.The prevalence of mental disorders was 27.1% in the present study.Chi-square tests showed that the chronicdisease costs,disability,social support and physical exercises were the influencing factors of the mental health status.Multivariable logistic regression analysis demonstrated that medical insurance,chronicdisease costs,social support and physical exercises were important factors influencing the mental health of the elderly.Conclusion It is important to emphasize the spiritual support for the aging population and the fading family support in China.We should improve the social support for the elderly and build up mental supporting services so as to improve their mental health.
BACKGROUND The prevalence and mortality rate of chronic kidney disease (CKD) are increasing year by year, and it has become a global public health issue. The economic burden caused by CKD is increasing at a rate of 1% per year. CKD is highly prevalent and its treatment cost is high but unfortunately remains unknown. Therefore, early detection and intervention are vital means to mitigate the treatment burden on patients and decrease disease progression. OBJECTIVE In this study, we investigated the advantages of using the random forest (RF) algorithm for assessing risk factors associated with CKD. METHODS We included 40,686 people with complete screening records who underwent screening between January 1, 2015, and December 22, 2020, in Jing’an District, Shanghai, China. We grouped the participants into those with and those without CKD by staging based on the glomerular filtration rate staging and grouping based on albuminuria. Using a logistic regression model, we determined the relationship between CKD and risk factors. The RF machine learning algorithm was used to score the predictive variables and rank them based on their importance to construct a prediction model. RESULTS The logistic regression model revealed that gender, older age, obesity, abnormal index estimated glomerular filtration rate, retirement status, and participation in urban employee medical insurance were significantly associated with the risk of CKD. On RF algorithm–based screening, the top 4 factors influencing CKD were age, albuminuria, working status, and urinary albumin-creatinine ratio. The RF model predicted an area under the receiver operating characteristic curve of 93.15%. CONCLUSIONS Our findings reveal that the RF algorithm has significant predictive value for assessing risk factors associated with CKD and allows the screening of individuals with risk factors. This has crucial implications for early intervention and prevention of CKD.
Background The prevalence and mortality rate of chronic kidney disease (CKD) are increasing year by year, and it has become a global public health issue. The economic burden caused by CKD is increasing at a rate of 1% per year. CKD is highly prevalent and its treatment cost is high but unfortunately remains unknown. Therefore, early detection and intervention are vital means to mitigate the treatment burden on patients and decrease disease progression. Objective In this study, we investigated the advantages of using the random forest (RF) algorithm for assessing risk factors associated with CKD. Methods We included 40,686 people with complete screening records who underwent screening between January 1, 2015, and December 22, 2020, in Jing’an District, Shanghai, China. We grouped the participants into those with and those without CKD by staging based on the glomerular filtration rate staging and grouping based on albuminuria. Using a logistic regression model, we determined the relationship between CKD and risk factors. The RF machine learning algorithm was used to score the predictive variables and rank them based on their importance to construct a prediction model. Results The logistic regression model revealed that gender, older age, obesity, abnormal index estimated glomerular filtration rate, retirement status, and participation in urban employee medical insurance were significantly associated with the risk of CKD. On RF algorithm–based screening, the top 4 factors influencing CKD were age, albuminuria, working status, and urinary albumin-creatinine ratio. The RF model predicted an area under the receiver operating characteristic curve of 93.15%. Conclusions Our findings reveal that the RF algorithm has significant predictive value for assessing risk factors associated with CKD and allows the screening of individuals with risk factors. This has crucial implications for early intervention and prevention of CKD.
Objective:To study six cities for their medical insurance schemes.The aims are to get the similarities and differences of the medical insurance schemes of the six cities.The six cities include Dongguan,and Zhuhai located in eastern China,Qianjiang and Ezhou in central China,Chengdu and Chongqing in western China.Methods:The paper made a comparative analysis focused on the model of medical insurance,coverage,premium levy,beneficisary,medical assistance and administration.Results and Conclusion:In accordance with the various parts of economic strength and local conditions,the cities speed up the integration of urban and rural medical care system.However,there are some problems,such as,risk at merging the two systems,system design flaws,non-smooth of linkage between security schemes,non-scientific of levels on medical insurance level.
Approximately one-third of gastroesophageal reflux disease (GERD) patients have symptoms resistant to proton pump inhibitor (PPI). We used the high-resolution manometry (HRM) and multichannel intraluminal impedance-pH (MII-pH) monitoring to investigate potential predictors of PPI failure in non-erosive reflux disease (NERD) patients.One hundred and seventeen NERD patients were included, within which there were 44 PPI failure patients. The symptomatic questionnaire GerdQ, HRM and 24-hour MII-pH monitoring were performed before PPI therapy. PPI failure was defined as persistent reflux symptoms for more than 1 day during the last week on esomeprazole (20 mg twice daily) for continuous 4 weeks. The predictors for PPI failure were investigated by multivariable logistic regression analysis.Proton pump inhibitor failure patients had lower body mass index (BMI) and more concomitant functional dyspepsia (FD) symptoms. PPI failure patients had a higher percentage of type I esophagogastric junction (EGJ) morphology (p = 0.005), increased EGJ augmentation (p = 0.000), higher prevalence of esophageal motility disorders (p = 0.005) and a higher ratio of negative symptom index (SI, p = 0.000). Multivariable regression analysis showed that concomitance of FD symptoms, EGJ augmentation and negative SI were independent risk factors for PPI failure in NERD.Approximately half of PPI failure patients were found to have esophageal motility disorders in HRM. The independent risk factors for PPI failure in NERD were concomitant FD symptoms, increased EGJ augmentation and negative SI.
Focusing on Chinas medical insurance scheme which covers all employers and employees in urban areas, this research aims to assess the distributional impacts of medical insurance policies and to predict medical expenses by using microsimulation techniques. As an important part of the project, this article provides a brief overview of Chinas medical insurance reform of urban employees and detail the techniques and processes to construct a basefile in 2005 for projecting the medical expenditures for urban employees over the period of 2006-2010. The main data used are administrative medical records of medical insurance participants provided by the Bureau of Labour and Social Security of Kunming, Yunnan Province. Along with the initial analysis for the raw datasets and age processing and adjustment for the individual records, monthly income information was imputed and personal savings accounts were established for each individual record. Important modelling parameters such as death rates and income adjustment factors were constructed. Furthermore, this article identifies medical insurance for government officials by using the combination of logarithm curve fitting and binary discriminant analysis. Based on this basefile, a static microsimulation model can be built to assess the implementation effects of the medical insurance policy and analyse the impact of the medical insurance scheme on urban employees.
Objective: To analyze the health service demands and the security status,and then to propose the strategies to improve the service.Methods: The data of fourth National Health Service survey were analyzed with description analysis method.Results: The health security system has not been set up for the aged,so the disease burden was higher in the aged than other people,and also the social support service item has not adopted in the security item.The development of medical security of the aged was lag of other social security.Conclusion: The health security of the aged should be paid attention to and the involved items and support level should be enlarged.In the construction of the security system,the home support should be taken as the priority,and the community support as the future support.
Background and study aim: The aim of this study was to determine the prevalence, characteristics, and risk factors of erosive esophagitis and Barrett's esophagus in an adult Chinese population without gastroesophageal reflux symptoms.
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