Hemoglobin levels in Tibet: different effect of age and gender for Tibetans vs Han

Tibetans form a population which has resided on the Qinghai–Tibetan plateau for thousands of years, and are reported to have less hemoglobin than Han Chinese lowlanders who have migrated to the plateau. However, for various altitudes, detailed comparisons of hemoglobin in the two ethnic groups has not been reported. We investigated the hypothesis that the effects of altitude, age, and gender on hemoglobin concentration would differ between Han and Tibetan residents of the plateau. Hematological parameters for both genders were determined in healthy Tibetan adults (n=3,000) and children (n=332), and healthy Han Chinese adults (n=2,612) and children (n=275), aged 5–60 years living at four different altitudes (mean altitude of 2,664, 3,813, 4,525, and 5,200 m). Hemoglobin values increased with altitude for all ages in both ethnic groups and in both genders. The gain in hemoglobin with altitude had the rank order: Han males > Han females > Tibetan males and females. Even before puberty, Han children had more hemoglobin than Tibetan children. An effect of age on hemoglobin was seen at the time of puberty in men, but not in women. A positive correlation was found between hemoglobin concentration and age in adult Han males and females, but not in Tibetan males, and only at the higher altitudes, in Tibetan females. In both Tibetans and Hans, males had higher hemoglobin values than females at each altitude, but the gender differences increased with altitude in Han, whereas it either decreased or did not change in Tibetans. Examination of hemoglobin levels by histogram showed non-Gaussian distributions: Tibetan men and women had skewing to higher values, whereas Han men and women had skewing in the opposite direction. We conclude that increasing age and the effect of gender in Tibetans are associated with different hemoglobin responses to altitude than in Han, and we speculate that genetic influences may be involved.     

Measuring contraceptive values: An alternative approach

Previous assessments of individuals' values for various contraceptive consequences have employed one of four methodologies: free elicitation, direct ratings, multiple regression, or factor analysis. All four methodologies are flawed because they produce group rather than individual values, rely on rating scales, and fail to incorporate information regarding consequence trade-offs. Axiomatic conjoint measurement is proposed as an alternative methodology and used to determine individuals' values for a selected set of contraceptive consequences at two stages of the family-planning career.Preparation of this paper was supported in part by Grants HD-10802 and HD-14403 from the National Institute of Child Health and Human Development. Appreciation is due the Statistical Computing Facility of the University of California at Berkeley. Requests for reprints should be sent to the Publications Librarian, Center for Research on Judgment and Policy, Muenzinger Psychology Building, University of Colorado, Boulder, Colorado 80309-0344.     

Development of an EQ-5D Value Set for India Using an Extended Design (DEVINE) Study: The Indian 5-Level Version EQ-5D Value Set

ObjectivesThis study aimed to develop the Indian 5-level version EQ-5D (EQ-5D-5L) value set, which is a key input in health technology assessment for resource allocation in healthcare.MethodsA cross-sectional survey using the EuroQol Group’s Valuation Technology was undertaken in a representative sample of 3548 adult respondents, selected from 5 different states of India using a multistage stratified random sampling technique. The participants were interviewed using a computer-assisted personal interviewing technique. This study adopted a novel extended EuroQol Group’s Valuation Technology design that included 18 blocks of 10 composite time trade-off (c-TTO) tasks, comprising 150 unique health states, and 36 blocks of 7 discrete choice experiment (DCE) tasks, comprising 252 DCE pairs. Different models were explored for their predictive performance. Hybrid modeling approach using both c-TTO and DCE data was used to estimate the value set.ResultsA total of 2409 interviews were included in the analysis. The hybrid heteroscedastic model with censoring at ?1 combining c-TTO and DCE data yielded the most consistent results and was used for the generation of the value set. The predicted values for all 3125 health states ranged from ?0.923 to 1. The preference values were most affected by the pain/discomfort dimension.ConclusionsThis is the largest EQ-5D-5L valuation study conducted so far in the world. The Indian EQ-5D-5L value set will promote the effective conduct of health technology assessment studies in India, thereby generating credible evidence for efficient resource use in healthcare.     

Directions of Changes in the Health Values of Dairy Products in the Opinion of Consumers

The aim of our research was to assess whether and to what extent the perceived change in the content of selected ingredients in dairy products is important for Polish consumers in accepting the enhancement of the health benefits of dairy products, including yogurt. The data were collected using a CAPI (Computer Assisted Personal Interview) survey on a sample of 983 consumers. The logistic regression model was used to predict the behavior of consumers associated with their willingness to accept the health aspects of improving dairy products. The results indicated that changes in the level of selected ingredients enhanced the willingness to accept increasing the health value of the product. The socio-demographic characteristics of the participants were not associated with the degree of their willingness to accept the improvement of the perceived health attributes. Practitioners in the dairy industry and policy makers can benefit from these results. When designing food products, it is worth focusing on increasing the nutritional value and enhancing the health value of food that is perceived by consumers as generally possessing positive health benefits, rather than on food that is perceived by them as possessing negative qualities.     

Reference Values and Psychometric Properties of the Quality of Life After Traumatic Brain Injury-Overall Scale in Italy,The Netherlands,and the United Kingdom

ObjectivesThe Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS) is a short screening instrument for assessing disease-specific health-related quality of life (HRQoL) after traumatic brain injury. To date, no reference values are available for the QOLIBRI-OS in general populations. Thus, this study aimed to establish reference values for the QOLIBRI-OS in general population samples from Italy, The Netherlands, and the United Kingdom.MethodsData were collected using an online survey. The total sample comprised 11759 participants, consisting of 3549 Italian, 3564 Dutch, and 4646 British subjects. In this sample, 49% of the total sample did not report any health complaints, whereas 51% had at least 1 chronic health condition. Reference values were deduced for the QOLIBRI-OS for health-condition–related samples and total general population samples per country. To ensure the comparability of these values, measurement invariance was assessed using a multigroup confirmatory factor analysis. Covariates characterizing the reference values were selected with the help of regression analyses.ResultsThe confirmatory factor analysis confirmed that the QOLIBRI-OS scores measured the same traumatic brain injury–specific HRQoL construct across the 3 countries. Healthy individuals reported significantly higher HRQoL than individuals with at least 1 chronic health condition. Older age and higher education levels were significantly associated with higher HRQoL.ConclusionsBecause the reference values displayed differences in terms of age and education level across the 3 countries, we recommend using country-specific reference values stratified by sociodemographic and health status in research and clinical practice.     

东菱精纯克栓酶对荷瘤裸鼠全血Casson值的影响

为观察并了解东菱精纯克栓酶对荷瘤裸鼠全血Casson值的影响,采用锥板式粘度计对移植了胃癌和鼻咽癌的荷瘤裸鼠使用东菱精纯克栓酶前后的全血粘度进行检测,并采用线性回归的方法求出各组Casson粘度(CV)及Casson屈服值(CY)。结果显示,使用东菱精纯克栓酶后两组荷瘤裸鼠全血(CV)值皆明显下降(P＜0.01);(CY)值在胃癌组明显下降(P＜0.01),鼻咽癌组无明显变化(P＞0.05)。结果表明,使用东菱精纯克栓酶对荷瘤裸鼠的血液流变学参数有明显改善,提示有可能将其应用于临床预防肿瘤转移及扩散。     

磁性医院管理对基层托管二级民营医院护士离职率的影响

目的 探讨磁性医院管理在基层托管二级民营医院的实践效果.方法 将磁性医院管理应用于托管二级民营医院:培养护理管理者领导力、建立有效激励机制、构建支持性工作环境、打造磁性医院关爱文化等,增强临床护士凝聚力.比较实施前后护士职业价值观、离职意愿及离职率状况.结果 实施磁性医院管理实践后,临床护士职业价值观评分显著高于实施前,离职意愿评分显著低于实施前(均P＜0.05);离职率由2017年33.05％降至2020年6.19％ (P＜0.01).结论 磁性医院管理能引导临床护士建立正确的职业价值观,降低护士离职意愿及离职率.     

A TLC screening program for 170 commonly used pesticides using the corrected Rf value (R f c value)

Summary This article reports TLC data (corrected R_f values; R _f ^c values) of 170 commonly used pesticides which are regularly encountered in toxicological analysis. Silica gel was used as the stationary phase and three binary systems were chosen as solvents.     

京剧嗓音的声学分析及音域特征

目的　从声学角度客观地检测京剧的嗓音特征 ,为京剧演唱者嗓音的训练和保护提供参考。方法　对 73名 1 6～ 5 7岁不同行当的专业京剧演员或学员 ,利用Dr Speech计算机频谱分析系统对元音 /a/、/i/歌唱舒适音和唱段进行声学参数的检测和分析。结果　各行当元音 /a/、/i/歌唱舒适音的基频 (fundamentalfrequency,F0 )分别是 :丑角 (2 72 6± 42 0 )Hz( x±s ,下同 )、(30 4 2± 2 2 1 )Hz;小生 (499 3± 34 0 )Hz,(485 4± 1 8 7)Hz;老生 (335 6± 6 0 0 )Hz,(31 7 9± 45 1 )Hz ;花脸 (31 9 0±6 1 3)Hz,(34 0 1± 6 8 8)Hz;老旦 (42 7 6± 47 2 )Hz,(437 7± 45 8)Hz ;花旦 (5 35 8± 48 8)Hz,(5 6 1 6± 2 9 2 )Hz ;青衣 (5 48 0± 6 9 5 )Hz,(5 43 5± 79 3)Hz;其它声学参数 :频率微扰 (pitchperiodperturbation,或Jitter)、振幅微扰 (amplitudeperturbation ,或Shimmer)和声门噪声能量 (也称标准化噪声能量级 ,normalizednoiseenergy ,NNE)均在软件提供的正常值范围内 ;京剧演员歌唱音域的跨度为 1 7～ 2 8个八度 ,最低音和多数最高音均比西洋唱法的高音声部相应的值高。结论　京剧嗓音有着独特的声学特征 ;结果对其嗓音的训练和保护有一定的临床参考