Investigation and Analysis of Lung Cancer Risk Factors in the Health Check-Up Population

Objective: To investigate and analyze the risk factors of lung cancer in the population of health checkups. Methods: A total of 500 cases of the health check-up population were selected for data study. Surveyed showed that 19 cases of lung cancer were grouped as the lung cancer group and the remaining 481 cases made up the control group, and the risk factors were analyzed. Results: Among men, there was a significant proportion of individuals aged 60-69 years old, and women aged 30-39 years old. Additionally, individuals aged 60 and above were at increased risk of developing lung cancer. The results of the multifactorial analysis were that the risk factors affecting the detection of lung cancer in healthy people were smoking history, family history of lung cancer, secondhand smoke, history of respiratory diseases, psychosomatic factors, living environment, and kitchen fumes. Conclusion: People over 60 years of age were prone to early lung cancer, followed by individuals aged 30-39 years. It is important to identify the risk factors of lung cancer to strengthen the screening of high-risk groups for early detection and treatment.

Analysis of the Prevalence Characteristics of Lung Nodules and Their Influencing Factors in The Health Check-Up Population

Objective: To study the prevalence characteristics of pulmonary nodules and their influencing factors in the health check-up population. Methods: A total of 500 cases of health checkups were selected for the data study to analyze the detection and prevalence characteristics of pulmonary nodules. The influencing factors between the pulmonary nodules group and the no pulmonary nodules group were analyzed. Results: A total of 209 cases were detected, of which there were more males than females, and for female patients, the detection rate increased with age (P < 0.05). The distribution of gender, age, smoking, respiratory symptoms, and exposure to kitchen fumes between the two groups was compared (P < 0.05). The multifactorial analysis concluded that risk factors include, respiratory symptoms, older age, exposure to kitchen fumes, and smoking. In addition, patients who exercised more had a lower risk of developing lung nodules. Conclusion: The detection rate of pulmonary nodules was high in the health check-up population and the influencing factors analyzed involved the presence of respiratory symptoms, older age, kitchen fume exposure, and smoking, while the positive influencing factor was increased exercise.

Awareness of initiative practice for health in the Chinese population:A questionnaire survey based on a network platform

BACKGROUND In 2016,the Chinese government issued the Healthy China 2030 plan,which also produced the initiative practice for health(IPFH)concept.However,people’s knowledge and awareness of the IPFH are unclear.AIM To investigate awareness of IPFH in the Chinese population and explore the relevant influential factors.METHODS An internet-based self-designed questionnaire survey was used to collect respondents’demographic characteristics and awareness of health and the IPFH from March 26 to April 18,2020.IPFH consciousness was assessed by the scores for different related questions.The Student’s t test,the Chi-square test,and multiple logistic regression analysis were performed to analyze the differences and influencing factors.RESULTS A total of 2678 valid questionnaires were collected.Of the respondents,973(36.3%)had heard of the IPFH concept.In addition,89.5% of participants agreed with the view that the IPFH is beneficial to improving quality of life,and over half thought that a regular schedule,a reasonable diet,tobacco and alcohol control,a cheerful mood,specific life goals and plans,taking the initiative to accept health-related education and implement health knowledge,good interpersonal relationships,and regular physical examinations were closely related to the IPFH.The majority of respondents paid attention to their health and usually obtained health-related knowledge via social media and were also willing to promote the IPFH.Most of the participants underestimated the role of hospitals,family doctors,and health managers in promoting the IPFH.Age,monthly income,and medical-related work experience were the influencing factors for IPFH awareness.CONCLUSION The Chinese population has limited knowledge of the IPFH.People with strong IPFH awareness are older,earn more,and have medical-related work experience.

The Study of Health Effects of Vinyl Chloride AirPollution on Population

A series of indicators, including serum lysozyme activity, G-banding chromosome aberration (G-banding CA) analysis, sister chromatid exchanges (SCEs), chromosome aberration (CA), T-lymphocyte transformation rate (TcTR),-GT, GPT and AKP, were employed in the present survey among occupationally vinyl chloride (VC) exposed workers and inhabitants living in VC polluted area in a polyvinyl chloride (PVC) factory. The results showed that the serum lysozyme (S-LZM) activities in Group 3 (adult inhabitants exposed to 0.20 mg/m3 VC for at least 8 years), Group 2 (workers exposed to 4.1 mg/m3for at least 7 years occupationally), Group 1 (workers exposed to 25.7 mg/m3 for at least 2 years) were significantly higher than control. G-banding CA analysis showed that the total chromosome breakage rates in both Groups 1 and 2 were higher, but no difference existed between Group 3 and control. Only Group 1 was observed having higher SCEs, CA level and lower TcTR than control. AKP levels in Groups 1 and 2 were higher than control,but noγ-GT and GPT differences were found among groups. The study also suggests that G-banding CA analysis is more sensitive than CA and SCEs

Comparison of Community Health between Rural and Urban Areas in View of the Impact of the COVID-19 Pandemic: Global Perspective through a Literature Review

The progressive aging of society is expected to lead to the development of effective integrated community-based care system considering the characteristics based on community environments. However, the COVID-19 pandemic has influenced population health worldwide. This study aimed to examine disparities in population health and health-related factors between rural and urban communities during the COVID-19 pandemic. A literature search was conducted using PubMed, Medline, and CINAHL for articles published up to September 2022 with the following search terms: community health, rural, urban, and COVID-19. A total of 105 articles were identified, of which three articles with a cross-sectional quantitative research design met the inclusion criteria. Two articles focused on mental health, and among them, one recognized a significant disparity between rural and urban areas. Four health-related factors in view of the COVID-19 pandemic in rural and urban areas were perceived, including knowledge, behavior, lifestyle, and social support. And, two factors: health-related knowledge and health-related behavior, were perceived as the significant disparities between rural and urban during the COVID-19 pandemic. The further efforts will be needed to pursue effective integrated community-based care system during and post-COVID-19, taking into account community environment at both community and individual levels.

Role of traditional Chinese medicine in the initiative practice for health

To achieve awareness of the initiative practice for health concept in the Chinese population,traditional Chinese medicine(TCM)doctors should popularize TCM culture and knowledge among young people,people with a low level of education,in low-income populations,and in rural populations.

Risk factors for major gastrointestinal bleeding in the general population in Finland

BACKGROUND Data on non-drug related risk-factors for gastrointestinal bleeding(GIB)in the general population are limited,especially for life-style factors,clinical measurements and laboratory parameters.AIM To identify and investigate non-drug risk factors for major GIB in the general population of Finland.METHODS We performed a retrospective cohort study using data from the FINRISK health examination surveys,which have been conducted every 5 years across Finland from 1987 to 2007.Participants were adults aged 25 years to 74 years,excluding those with a previous hospitalization for GIB.Follow-up from enrollment was performed through linkage to national electronic health registers and ended at an event of GIB that led to hospitalization/death,death due to any other cause,or after 10 years.Covariates included demographics,socioeconomic and lifestyle factors,clinical measurements,laboratory parameters and comorbidities.Variable selection was undertaken using Least Absolute Shrinkage and Selection Operator(LASSO)and factors associated with GIB were identified using Cox regression.RESULTS Among 33,508 participants,403(1.2%)experienced GIB[256 men(63.5%);mean age,56.0 years(standard deviation(SD)±12.1)]and 33105 who did not experience GIB[15768 men(47.6%);mean age,46.8(SD±13)years],within 10 years of follow-up.Factors associated with a significantly increased risk of GIB were baseline age[per 10-year increase;hazard ratio(HR)1.62,95%confidence interval(CI):1.42-1.86],unemployment(HR:1.70,95%CI:1.11-2.59),body mass index(BMI)(HR:1.15,95%CI:1.01-1.32),gamma-glutamyl transferase(GGT)(HR:1.05,95%CI:1.02-1.09),precursors of GIB(HR:1.90,95%CI:1.37-2.63),cancer(HR:1.47,95%CI:1.10-1.97),psychiatric disorders(HR:1.32,95%CI:1.01-1.71),heart failure(HR:1.46,95%CI:1.04-2.05),and liver disorders(HR:3.20,95%CI:2.06-4.97).Factors associated with a significantly decreased risk of GIB were systolic blood pressure(SBP)(HR:0.78,95%CI:0.64-0.96),6-10 cups of coffee a day(HR:0.67,95%CI:0.46-0.99),or>10 cups(HR:0.43,95%CI:0.23-0.81).CONCLUSION Our study confirms established risk-factors for GIB and identifies potential risk-factors not previously reported such as unemployment,BMI,GGT,SBP and coffee consumption.

Health Analytics, Economics and Medicine toward a 21st Century Health Care System

After a review of recent developments in precision medicine, population health sciences and innovative clinical trial designs, and in health economics and policy, we show how innovations in health analytics can capitalize on the advances in biomedicine and health economics towards developing a data-driven and cost-effective 21st century health care system. In particular, we propose a mutually beneficial public-private partnership that combines individual responsibility with community solidarity in building this health care system.

Contributions of Primary Health Care and Next Step Considerations: A Systematic Review

The essential consideration is the cornerstone of a solid medical care system that provides outstanding health outcomes at a low cost. Medical therapy has evolved over the previous century from concentrating on random etiologies to lifestyle, race, and environmental factors. The aim behind these changes is to serve the public health requirements by delivering frequent and easy services based on the individual, couple, or family. Accurate evaluation of the magnitude by which primary health care contributes to the health care system is essential to the improvement of these contributions and determining next step considerations. The number one factor has been associated with greater access to medical care, better health outcomes, and reduced hospitalization and ER (emergency room) visits. The number one consideration may also help balance the adverse effects of poor financial situations on well-being. Therefore, we need more primary care doctors in the US. Research is also necessary to understand which essential consideration models provide acceptable health results.

Promoting Healthy Longevity Should Start Young: A Life Course Journey

Introduction Throughout a woman’s life,several unique health characteristics are related to an increased risk of later disease morbidity and/or premature mortality(Fig.1).For instance,these include early age at menarche1,2(ie,“short,irregular or long menstrual cycles”)3,4,a history of infertility5,pregnancy loss6,several major pregnancy complications(eg,preeclampsia,gestational hypertension,gestational diabetes mellitus(GDM)and preterm delivery)7–9,and menopause characteristics(eg,long menopause transition period,early age at menopause,and the presence of vasomotor symptoms).

Climate change and population health research in China: Knowledge gaps and further directions

Climate change and its impact on population health have been well explored in China in recent years,especially health risk assessments such as studying its impact on the transmission and development of climate-sensitive infectious diseases and non-communicable diseases.However,knowledge gaps including using morbidity as health indicators(e.g.hospitalisations,ED visits,and ambulance call-outs),identifying disease attributable contributions to climate variability and burden of diseases due to climate change,calculating related healthcare costs,and developing climate change adaptation and mitigation strategies need to be addressed.Future research directions could focus on both mitigation and health adaptation studies,such as exploring active transportation and green hospitals,studying health co-benefits,identifying vulnerable populations,prioritizing resource allocation,building healthcare capacity and capability,evaluating intervention effect,developing tailored risk communication strategies and community health education packages for vulnerable communities in the context of climate change.

Process engineering for primary care:Quality improvement and population health

A fundamental paradox of the health care delivery systems in many industrialized nations is that desired population health metrics are often not achieved despite large expenditures in the health care delivery system.For example,the United States commits nearly 18%of its GDP to the health care delivery system,the largest amount of any nation,yet is 37th in achieving health or health care delivery metrics.This article addresses how general practice can be an important driver of population health in the Chinese health care delivery system through the application of quality improvement methods.The article shows examples of how the cause-and-effect diagram,the process map,and the plan,do,study,act(PDSA)cycle are important techniques to assist primary care practitioners for improving population health.

The Accountable Care Organization results:Population health management and quality improvement programs associated with increased quality of care and decreased utilization and cost of care

Objective:The Accountable Care Organization(ACO)model of health care delivery is based on new payment models for general practice to reward improved quality and decreased cost of care.Methods:Banner Health Network(BHN)is one of the original CMS Pioneer ACO programs and implemented a comprehensive disease management program based on the collaborative care model.Key performance indicators for CMS reflected quality and cost of care.Results:BHN has demonstrated both improved quality and cost savings in the first two years of the pilot program.The disease management program based on the collaborative care model appears to have improved patient health outcomes based on quality improvement measures.In addition the program has reduced emergency department and hospital utilization,resulting in cost savings.Conclusions:The BHN quality improvement program is the platform for analyzing and improving on the BHN ACO model.This model appears to have excellent application to the China health care system that is also focused on prevention and improvement of chronic disease and cost-effectiveness.

Pesticide exposures and respiratory health in general populations

Human exposures to pesticides can occur in the workplace,in the household and through the ambient environment.While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings,to the best of our knowledge,this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations.In this article,we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations.This article also highlighted questions arising from these studies,including our recent analyses using the data from the Canadian Health Measures Survey（CHMS）,for future research.We found few studies have addressed the impact of environmental pesticide exposures on respiratory health,especially on lung function,in general populations.In the studies using the data from CHMS Cycle 1,exposures to OP insecticides,pyrethroid insecticides,and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population,but no significant associations were observed for the herbicide 2,4-D.Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population,and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures.Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems,and thereafter providing greater benefit to the general population.

Population Development and Reproduction Health Education in Tibet

MY ancestors have lived in Lhasa, Tibet, for generations. I have personally witnessed the great changes in modern Tibetan society. The total population of the region has doubled since 1951. The Fourth National Census in 1990 revealed that the human fertility rate in the Tibet Autonomous Region was 27.60 per thousand, the natural population growth rate 18.40 per thousand, and the total fertility rate of women at childbearing age 4.22.

Life’s Essential 8 and risk of non-communicable chronic diseases:Outcome-wide analyses

Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life’s Essential 8 has been established.In this study,we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions(PAFs)of low-moderate CVH scores in the 44 NCDs.Methods:In the UK Biobank,170,726 participants free of 44 common NCDs at baseline were included.The Life’s Essential 8 composite measure consists of four health behaviours(diet,physical activity,nicotine exposure,and sleep)and four health factors(body mass index,non-high density lipoprotein cholesterol,blood glucose,and blood pressure),and the maximum CVH score was 100 points.CVH score was categorized into low,moderate,and high groups.Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition(ICD-10)code using linkage to national health records until 2022.Cox proportional hazard models were used in this study.The hazard ratios(HRs)and PAFs of 44 NCDs associated with CVH score were examined.Results:During the median follow-up of 10.85 years,58,889 incident NCD cases were documented.Significant linear dose-response associations were found between higher CVH score and lower risk of 25(56.8%)of 44 NCDs.Low-moderate CVH(<80 points)score accounted for the largest proportion of incident cases in diabetes(PAF:80.3%),followed by gout(59.6%),sleep disorder(55.6%),chronic liver disease(45.9%),chronic kidney disease(40.9%),ischemic heart disease(40.8%),chronic obstructive pulmonary disease(40.0%),endometrium cancer(35.8%),lung cancer(34.0%),and heart failure(34.0%)as the top 10.Among the eight modifiable factors,overweight/obesity explained the largest number of cases of incident NCDs in endocrine,nutritional,and metabolic diseases(35.4%),digestive system disorders(21.4%),mental and behavioral disorders(12.6%),and cancer(10.3%);however,the PAF of ideal sleep duration ranked first in nervous system(27.5%)and neuropsychiatric disorders(9.9%).Conclusions:Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs.Among CVH metrics,avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases,NCDs in digestive system,mental and behavioral disorders,and cancer.

A population-based approach to the management of depression in a patient-centered medical home

Objective:This article describes the implementation of a population-based strategy to man-age depression in a patient-centered medical home.Methods:Review of English language articles;description of specific protocols utilized in one medical home.Results:Depression is a global concern estimated to affect 350 million people worldwide.Rates for depression vary between the United States and the Peoples’Republic of China,possibly due to significant factors in under diagnosis of this often hidden burden.Given the comorbidity of depres-sion with other health factors and the need for ongoing monitoring and care of this chronic illness,primary care has become a significant part of treatment interventions.Utilizing electronic health records(EHR),our strategy included the creation of a patient registry;selection of evidence-based treatment guidelines and protocols for point of care procedures;patient outreach and screening.Conclusion:The population-based program we outline is highly dependent on the EHR and the flexibility of roles and responsibilities of clinical staff.Further investigation is warranted into improved patient outcomes.

Geographic and health system correlates of interprofessional oral health practice

Objective:This study explores geographic,system,and organizational constructs that predict medical care teams’willingness to administer fluoride varnish and conduct oral health risk assessments.Methods:A cross-sectional survey of voluntary health professionals attending trainings on interprofessional oral health practice was completed at ten meetings across the United States from April through September,2016.Bivariate and multivariate analyses were used to examine un-known correlates of oral health prevention and intervention at geographic,organizational,and sys-tem levels relating to the impact of referral mechanisms and systems as well as health information technology on fluoride varnish administration and risk-based oral evaluations.Results:A convenience cohort(n=560)from 44 states was examined.Most(68.7%,n=385)agreed with the dependent variable“medical providers at our site,or part of our network,are admin-istering fluoride varnish and identifying oral health risk factors in the majority of patients seen.”In bivariate analysis,organization type(P=0.0067),having successful referral systems(P<0.0001),and electronic health record(EHR)utility(P<0.0001)were associated with the dependent vari-able.No geographic indicators were significant.All referral system indicators were significant in multivariate analysis.Dependable referrals(P<0.0001),EHR utility(P=0.0054),and type of re-ferral(P=0.0009)were predictors of the dependent variable.The odds of those reporting a depend-able referral system and dependent variable agreement were 4.5 times greater than for those who lacked dependable referral systems(odds ratio 4.54,confidence interval 2.79-7.39).The odds of those who had dependable EHRs and dependent variable agreement were 2.4 times greater than for those who lacked useful EHRs(odds ratio 2.4,confidence interval 1.29-4.37).Conclusion:The dependability of medical-to-dental referral systems and processes impacts the administration of fluoride varnish and identification of oral health risk factors by motivated primary care teams.Additionally,the ease of EHR use and the availability of electronic information exchange were found to impact primary care oral health practice.

New models for chronic disease management in the United States and China

In the United States(US)the role of the general practitioner in primary care is changing rapidly as the team leader in the new“Patient-centered Medical Home”model of care that is designed to improve the management of chronic disease.The“Collaborative Care Model”is an integrated model of treating multiple medical and behavioral conditions.These new approaches include a nurse case manager who serves as the key point of contact to provide education,facilitate treatment adherence,and guide the patient to improvements in nutrition and physical activity that cause obesity and chronic disease.A gap analysis was conducted comparing the US and Chinese general practitioner models for providing care to patients with chronic diseases.The results of the analysis were used to make recommendations for adding components of these models that are feasible and effective for Chinese general practitioners in community health centers.

Could wastewater analysis be a useful tool for China?——A review

Analysing wastewater samples is an innovative approach that overcomes many limitations of traditional surveys to identify and measure a range of chemicals that were consumed by or exposed to people living in a sewer catchment area. First conceptualised in 2001, much progress has been made to make wastewater analysis（WWA） a reliable and robust tool for measuring chemical consumption and/or exposure. At the moment, the most popular application of WWA, sometimes referred as sewage epidemiology, is to monitor the consumption of illicit drugs in communities around the globe, including China. The approach has been largely adopted by law enforcement agencies as a device to monitor the temporal and geographical patterns of drug consumption. In the future, the methodology can be extended to other chemicals including biomarkers of population health（e.g. environmental or oxidative stress biomarkers, lifestyle indicators or medications that are taken by different demographic groups） and pollutants that people are exposed to（e.g. polycyclic aromatic hydrocarbons,perfluorinated chemicals, and toxic pesticides）. The extension of WWA to a huge range of chemicals may give rise to a field called sewage chemical-information mining（SCIM） with unexplored potentials. China has many densely populated cities with thousands of sewage treatment plants which are favourable for applying WWA/SCIM in order to help relevant authorities gather information about illicit drug consumption and population health status. However, there are some prerequisites and uncertainties of the methodology that should be addressed for SCIM to reach its full potential in China.