Adherence to Dietary Guidelines Positively Affects Quality of Life and Functional Status of Older Adults

BackgroundNutritional parameters could influence self-perceived health and functional status of older adults.ObjectiveWe prospectively determined the association between diet quality and quality of life and activities of daily living.DesignThis was an observational cohort study in which total diet scores, reflecting adherence to dietary guidelines, were determined. Dietary intakes were assessed using a food frequency questionnaire at baseline. Total diet scores were allocated for intake of selected food groups and nutrients for each participant as described in the Australian Guide to Healthy Eating. Higher scores indicated closer adherence to dietary guidelines.Participants/settingIn Sydney, Australia, 1,305 and 895 participants (aged ≥55 years) with complete data were examined over 5 and 10 years, respectively.Main outcome variablesThe 36-Item Short-Form Survey assesses quality of life and has eight subscales representing dimensions of health and well-being; higher scores reflect better quality of life. Functional status was determined once at the 10-year follow-up by the Older Americans Resources and Services activities of daily living scale. This scale has 14 items: seven items assess basic activities of daily living (eg, eating and walking) and seven items assess instrumental activities of daily living (eg, shopping or housework).Statistical analyses performedNormalized 36-Item Short-Form Survey component scores were used in analysis of covariance to calculate multivariable adjusted mean scores. Logistic regression analysis was used to calculate adjusted odds ratios and 95% CIs to demonstrate the association between total diet score with the 5-year incidence of impaired activities of daily living.ResultsParticipants in the highest vs lowest quartile of baseline total diet scores had adjusted mean scores 5.6, 4.0, 5.3, and 2.6 units higher in these 36-Item Short-Form Survey domains 5 years later: physical function (P_trend=0.003), general health (P_trend=0.02), vitality (P_trend=0.001), and physical composite score (P_trend=0.003), respectively. Participants in the highest vs lowest quartile of baseline total diet scores had 50% reduced risk of impaired instrumental activites of daily living at follow-up (multivariable-adjusted P_trend=0.03).ConclusionsHigher diet quality was prospectively associated with better quality of life and functional ability.     

Acute toxicity of high concentrations of carbon dioxide in rats

Subterranean storage of carbon dioxide (CO₂) has been proposed to diminish atmospheric increases of this greenhouse gas. To contribute to risk assessment of accidental release associated with handling, transport and storage, rats were exposed to high concentrations (targets 40, 43 and 50 volume %) of CO₂. The oxygen concentrations dropped as a result, but were not supplemented. For each concentration, pairs of animals were exposed for different exposure durations to derive an exposure concentration–duration relation in which mortality is described as a function of Cⁿ × t (probit relation). A very high “n” value for the probit function could be derived from the data obtained at 40% and 43% CO₂, which indicates that for exposure durations longer than 30 min the LC50 decreases hardly with increasing exposure duration. Below 30 min the LC50 seemed to increase with decreasing exposure durations. The variability in the data of 43% and 50% CO₂, however, did not allow to derive a meaningful value of “n”.     

Risk assessment study of dioxins in sanitary napkins produced in Japan

A risk assessment study of dioxins in sanitary napkins produced in Japan was performed. The daily estimated exposure volume to dioxins was compared with the tolerable daily intake (TDI). The concentrations of dioxins such as polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (DL-PCBs) in seven sanitary napkins were measured using gas chromatography and mass spectroscopy analytical methods. Among the seven napkins, a range of 0.0044–0.076 pg TEQ/g dioxins was measured. Daily estimated exposure volume from sanitary napkins was calculated as follows: (dioxin volumes in a sanitary napkin (0.0044–0.076 pg TEQ/g) × pulp weight in a sanitary napkin (11.2 g) × used napkin numbers/d (7.5) × the number of days/month that women use sanitary napkins (7) × skin absorption rate (0.03) × used years (40))/(average body weight of women (50 kg) × the number of days in the month (30) × life years (86)). Daily exposure volumes were estimated to be 0.000024–0.00042 pg TEQ/kg/d. For hazard assessment, we used 0.7 pg TEQ/kg/d which was the lowest level of TDI among TDI values reported by international agencies. When the daily exposure volume was compared with the TDI, the former was approximately 1666–29,166 times less than the latter. This fact indicated that the risk of exposure to dioxins from sanitary napkins produced in Japan was negligible.     

满洲里市2013全年全人群死亡病例监测结果分析

目的回顾性分析内蒙古满洲里市居民2013年死亡原因,掌握主要死因与人群分布特征,为政府卫生决策和疾病预防控制提供科学依据。结果 2013年满洲里市居民死亡1 168例,死亡率为694/10万。从≥30岁年龄组开始死亡率随年龄增加而升高,65岁上升趋势明显加剧。结论循环系统疾病、肿瘤、呼吸系统疾病、疾病和死亡的外因、消化系统疾病是满洲里市居民死亡的五大主要影响因素。可见以循环系统疾病、肿瘤等疾病为代表的慢性非传染性疾病严重威胁着满洲里市居民的生命健康。慢性病的防治工作应从早期、一级预防抓起,长期坚持[1]。     

Variations in the Hospital Standardized Mortality Ratios in Korea

Objectives:

The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care.

Methods:

All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities.

Results:

For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR.

Conclusions:

We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.     

单唾液酸四己糖神经节苷脂钠对Binswanger病患者认知力及日常生活能力的影响

目的观察单唾液酸四己糖神经节苷脂钠对Binswanger病患者认知力及日常生活能力的影响。方法将56例Binswanger病患者随机分为治疗组和对照组各28例,两组患者均予常规治疗,治疗组患者在此基础上给予单唾液酸四己糖神经节苷脂钠静滴,对照组患者给予胞二磷胆碱静滴,14天后采用MMSE量表和ADL量表评价两组患者的认知力及日常生活能力变化情况。结果治疗组患者MMSE量表改善总有效率为75％、ADL量表改善总有效率为67．86％,对照组患者MMSE量表改善总有效率为35．71％、ADL量表改善总有效率为32．14％。结论单唾液酸四己糖神经节苷脂钠治疗Binswanger病能够较好改善患者认知力及日常生活能力。     

Orem 自理模式在神经内科患者护理中的应用效果

目的探讨Orem自理模式在神经内科脑卒中患者护理中的应用效果。方法将102例脑卒中患者随机分为观察组和对照组,每组各51例。对照组给予常规康复护理,观察组运用Orem自理模式给予指导并贯穿于常规康复护理中,比较两组患者的Barthel指数、Fud—Meyer评分、生存质量评分。结果入院4周后,观察组的生存质量评分明显高于对照组（P〈0．05）;出院时,观察组的Barthel指数和Fugl—Meyer评分明显高于对照组（P〈0．01）。结论Orem自理模式运用于脑卒中患者的护理中能提高其日常生活活动能力、运动功能和生活质量。