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Background In the context of the national efforts to promote the development of home care services for the elderly, chronic diseases and disabled patients, the adoption of professional assessment tools that can effectively assess the health of patients in the home environment and meet the needs of care services is an important guarantee to accurately match the needs of patients for home medical care. Objective To sinicize the Community Health Intensity Rating Scale (CHIRS) and evaluate its reliability and validity in the elderly patients with chronic diseases in the community. Methods After obtaining authorization from the original author, the translation, back translation and cultural adaptation process of the Brislin model were followed to form the Chinese version of CHIRS. From March to June 2021, a convenience sampling method was used to select elderly patients managed by a community health service center (station) in Chengdu as the research subjects. Expert consultation was used to evaluate the content validity of the scale; the internal consistency coefficient was used to test the reliability of the scale and to verify its practicality. Results A total of 244 patients were investigated and completed the household questionnaire, with a valid recovery rate of 100.0%. The expert consultation results showed that the S-CVI/ave of the Chinese version of CHIRS was 0.98, and the I-CVI ranged from 0.71 to 1.00; the overall Cronbach's α coefficient was 0.884, and the Cronbach's α coefficients for the four dimensions ranged from 0.593 to 0.787, the predictive validity results showed that the Spearman correlation coefficients of CHIRS result with self-rated health status and demand for home care services were -0.611 (P

Background In the context of increasing aging, diversified medical needs of the elderly and the constrains of medical resources, the demand for home-based medical services is increasing. Therefore, the development of home-based medical services are strongly encouraged in China. Sichuan Province, as a pilot area for geriatric home-based medical services, is currently operating mainly in primary health care institutions, and it is necessary to explore its condition and the current situation of service development. Objective To investigate the condition and current situation of home-based medical service of primary health care institutions in Sichuan Province, so as to provide reference for further promoting the standardization and development of home-based medical services. Methods From August to October 2021, a convenience sampling method was used to select the relevant persons in charge of 62 primary health care institutions in 7 cities in Sichuan Province as the subjects. Through self-designed questionnaires, data collection and survey analysis were conducted on the general information, human resources, the development of home health care and obstacles of the situations. Results Among the 62 primary health care institutions, the number of full-time medical staff varied widely, ranging from 10 to 316, with a median of 40 (40). The average proportion of medical staff to full-time employees was (84.9±11.3) %; the median percentage of physicians with junior titles or lower was 45.5% (24.2%), and the median percentage of nurses with junior titles or lower was 71.9% (34.2%) ; the medical-to-nursing ratio ranged from 0.43 to 2.63, with an average of (1.44±0.50). The differences were statistically significant when comparing the participation in accreditation of graded hospitals and part-time medical and nursing staff with the different locations of the institutions (P

Background With the trend of population aging, disabled or semi-disabled elderly people suffering from various chronic diseases have an urgent demand for home medical care services, but there are greater medical risks and safety hazards for primary health care workers to provide home medical care services, and strengthening the safety management of home medical care services is conducive to increasing the willingness of primary health care workers to provide home medical care services. Objective To investigate the safety support of home care services in primary health care institutions and the willingness of medical personnel to provide home care services, so as to provide a reference basis for further promoting the development of home medical care services. Methods From August to October 2021, 1 131 cases of medical personnel from 49 primary health care institutions in five economic regions of Sichuan Province were selected by convenience sampling method. A self-designed questionnaire was used to collect data in the form of an electronic questionnaire called "Questionnaire Star". The questionnaire included general information of medical staff (8 items) , experience of providing medical care at home (2 items) , safety support of medical staff by medical institutions (7 items) , and willingness of medical staff to provide home care (1 item) . The willingness of medical personnel to provide home medical care services was compared across different characteristics, and binary Logistic regression was used to analyze the factors influencing medical personnel's willingness to provide home medical care services. Results Of the 1 131 primary care medical personnel, 692 (61.18%) reported experiences with home medical care services, 193 (17.06%) reported adverse events or safety events during the services, 531 (46.95%) reported that their medical institutions had not assessed the safety risks of patients receiving home medical care services, 199 (17.60%) reported that their institutions had assessed the safety risks of medical staff visiting the home, 299 (26.44%) reported that the app location system was used in the process of home services, 273 (24.14%) reported that medical staff equipped with devices such as alarms and delay warnings, 807 (71.35%) reported that they did not receive service support from other medical staff within their institutions during home medical care services, 303 (26.79%) and 352 (31.12%) indicated that the institution had organized special seminars on home medical care services and received special training on home medical care services, respectively, 853 cases (75.42%) of medical staff were willing to provide home medical care services. The results of binary Logistic regression analysis showed that the type of primary health care institution with which they worked, the professional and technical titles currently employed, assessing the safety risk of patients receiving home medical care services, using alarm and delayed warning devices during home medical care services, and attending special training on home medical care services had an effect on the medical staff's willingness to provide home medical care services (P

Background At present, the recurrence rate of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is relatively high. But there are relatively few studies and most medical staff are not aware of it. Objective A comparative study of children with recurrent and non-recurrent anti-NMDAR encephalitis was conducted to improve clinicians' understanding of anti-NMDAR encephalitis and its recurrence-related factors, in order to provide evidence for individualized treatment of children with anti-NMDAR encephalitis and reduce the recurrence rate. Methods The clinical data of 54 hospitalized children diagnosed with anti-NDMAR encephalitis in the Department of Neurology, Hebei Children's Hospita, Hebei Medical University from January 2016 to December 2021 were retrospectively analyzed. According to the recurrence situation, the children were divided into non-recurrence group and recurrence group. The clinical characteristics of children with anti-NDMAR encephalitis were analyzed, including gender and age distribution, onset time, clinical symptoms and signs, routine examination of cerebrospinal fluid, imaging examination, electroencephalography, immunological examination, treatment and prognosis. The above-mentioned related indicators of the two groups were compared. Results The male-to-female ratio of the 54 children was 1.16∶1, and the school-age group (≥7 years old) accounted for 51.8%; The onset time was higher in summer (June-August) (33.3%) . The clinical symptoms were diverse, and the most common clinical symptom was epilepsy, accounting for 61.1%; 38 cases (70.4%) had abnormal cerebrospinal fluid routine examination results, mainly manifested as increased leukocyte and mildly increased protein in cerebrospinal fluid; MRI examination of brain of 25 children (46.3%) showed abnormal signals, the most common abnormal signal was in the frontal lobe, followed by the basal ganglia and thalamus; 6 cases (11.1%) were given immunoglobulin for ≥2 rounds, and 5 cases (9.3%) were given hormone shock ≥ after 2 rounds, 7 cases (13.0%) received second-line immunotherapy, 31 cases (57.4%) received antiepileptic drugs; 26 cases (48.1%) achieved complete remission. There was no significant difference in gender, age distribution, onset time, cerebrospinal fluid routine examination results, abnormal proportion of brain MRI examination results, video EEG examination results, CD8+T lymphocytes, CD4/CD8, total B lymphocytes, IgA, IgM, IgG, disease course before treatment, proportion of immunoglobulin ≥ 2 rounds, proportion of hormone shock ≥ 2 rounds, proportion of second-line immunotherapy, proportion of antiepileptic drugs, mRS at discharge, and proportion of complete remission between two groups (P>0.05) . The total T lymphocytes and CD4+ T lymphocytes in the recurrence group were lower than those in the non-recurrence group (P

BackgroundChronic diabetic complications are highly prevalent, which may be an underlying cause of diabetes-related disability and death. Regularly and continuously self-monitoring may contribute to early detection, diagnosis and treatment of various diabetic complications, which is essential to reducing the adverse consequences of diabetes, and is a key program in community-based management that should be highly valued.ObjectiveTo investigate the prevalence and associated factors (such as diabetes prevalence and monitoring and other factors) of behaviors of monitoring (self-observation and screening tests) to prevent chronic diabetic complications among type 2 diabetes patients receiving community-based management.MethodsThe convenience sampling was used to select 785 type 2 diabetes patients from Chengdu's central urban areas who received community-based type 2 diabetic management from May to November 2019. They were invited to attend a survey for understanding their socio-demographic information and monitoring behaviors to prevent chronic diabetic complications using a questionnaire developed by us.ResultsOnly 103 (13.1%) of the patients did not suffer from any chronic complications, and 435 (55.4%) suffered from both metabolic syndrome and chronic diabetic complications. The average total score for self-observation of chronic diabetic complications in the participants was (2.58±0.86) , but the average total score of regularly self-observation of pulsations of the dorsalis pedis artery was only (1.47±0.84) . The average total score of performing screening tests for chronic diabetic complications was (2.77±0.57) . The average score of diabetic retinopathy screening, peripheral neuropathy screening, and lower extremity vascular disease screening was (1.88±0.99) , (1.46±0.84) , and (1.47±0.84) , respectively. About 78.2% (614/785) of patients underwent screening tests following the doctors' advices. But only 9.9% (78/785) took the initiative to conduct regular tests. About 17.7% (139/785) and 49.0% (385/785) of the patients could not correctly manage the abnormal results of self-observation and the screening test results. Multiple linear regression analysis indicated that the duration of diabetes since diagnosis, prevalence of chronic diabetic complications, and management of self-observed abnormalities were associated with the score of self-observation of chronic diabetic complications (P

Aim and Objectives: This study aimed to investigate the intensity of needs for home health care services (HHCs) among elderly patients with chronic diseases and to identify the associated factors. Design: A cross‐sectional survey was conducted in Wuhou District, Chengdu, Sichuan Province, China, from April to November 2021. Methods: Convenient sampling was used to screen elderly patients with chronic diseases managed by Yulin Community Health Service Center. The questionnaires included general information and the Chinese version of the Community Healthy Intensity Rating Scale were completed according to patients' conditions. The data were analyzed using descriptive statistics and binary logistic regression. Results: A total of 371 patients (10.40%) completed the survey. The mean age of the elderly patients was 84.04 years (SD = 7.07); these patients suffered from 1 to 7 kinds of chronic diseases, and the most common were hypertension (78.98%) and diabetes (40.97%). The need intensity of patients for HHCs was moderate (41.51%) or severe (58.49%). For each additional chronic disease that patients suffered from, the need intensity increases by 1.289 times (OR = 1.289; 95% CI: 1.055–1.575, p =.013); in additional, those aged more than 90 years, with a personal monthly income less than 2500 yuan ($387.00), with a poor health current status, and with only basic medical insurance presented greater need intensity (p <.05). Conclusion: Our data analysis revealed that economic status, insurance condition, poor health status, and multiple comorbidities may be the most common factors associated with the need intensity for HHCs. These characteristics may help medical staff to identify and help those with urgent health problems. [ABSTRACT FROM AUTHOR]

Detailed understanding to the evolution of Neogene land mammals in East Asia and its intercontinental correlation has been impeded by the absence of an integrated biochronological system of this region. The numerous and diverse records of Neogene vertebrate fossils preserved in Inner Mongolia of northern China play a key role in the establishment of an independent biochronological framework in East Asia. However, most of these faunas are poorly constrained by independent chronological controls due to the scattered distribution of fossil localities and insufficient exposure of the fossiliferous strata. Additionally, age estimates by mammalian evolution and correlation often have uncertainties greater than ~1–2 million years. Here we present new magnetostratigraphic results of the Baogeda Ula Fauna, which was generally assigned an early Baodean Age (Late Miocene), or equivalent to the European MN12 zone (middle Turolian). Hipparion remains and associated vertebrate fossils were excavated from the upper part of the fluvio-lacustrine Baogeda Ula Formation near Abaga Banner, central Inner Mongolia of northern China. At least two layers of basalt sheet flows can be observed on top of the Baogeda Ula Formation. Our magnetostratigraphy, aided by published biochronology data and K–Ar ages of the lower basalt layer suggests that the Baogeda Ula Fauna consisting of three fossiliferous horizons can be placed within chron C4n.1n with an age range of 7.642–7.528 Ma. Thus, the Baogeda Ula Fauna becomes the first and only Baodean assemblage that is constrained by both magnetostratigraphy and radiometric ages, offering an anchoring point for future biochronological correlations.