Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

The Application of Formative Assessment in Interactive Comprehensive English Classroom Teaching

Teaching evaluation is an important part of the teaching process of college English courses,and effective formative assessment can reflect the entire teaching process from multiple perspectives and ensure the smooth achievement of teaching objectives.Formative assessment is an assessment that runs through the entire learning process,based on humanism and constructivism,with various forms of evaluation.

Artificial Intelligence Providing a More Optimized Assessment Tool for Comprehensive Geriatric Assessment

With the continuous development of science and technology,artificial intelligence(AI)is coming into our lives and changing our lives.Since China entered the aging society in 2000,the degree of population aging has deepened.Comprehensive geriatric assessment(CGA)is now the accepted gold standard for the care of older people in hospitals.However,some problems limit the clinical application,such as complexity and time consuming.Therefore,by analyzing previous studies,we summarize some existing AI tools in order to find a more optimized assessment tool to complete the entire CGA process.

Role of comprehensive geriatric assessment in screening for mild cognitive disorders

BACKGROUND The role of comprehensive geriatric assessment(CGA)in screening for mild cognitive disorders was not known.AIM To evaluate the role of CGA in screening for mild cognitive disorders.METHODS A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis.Using Petersen as the diagnostic gold standard,healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group.The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed.Patients'Montreal Cognitive Assessment(MoCA)and CGA screening results were compared,and the sensitivity and specificity were calculated to assess the screening role of CGA.RESULTS CGA assessment yielded higher diagnostic accuracy than MoCA.The results of the multivariate regression analysis showed no correlation of gender,age,body mass index and literacy with cognitive function.Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals(P<0.05).In the CGA scale,patients with mild cognitive impairment showed significantly lower Mini-mental State Examination,Miniature Nutritional Assessment and Berg Balance Scale scores,and higher Activity of Daily Living,Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals(P<0.05),whereas the other assessment scales showed no significant differences(P>0.05).The CGA provides higher diagnostic sensitivity and specificity than the MoCA(P<0.05).CONCLUSION CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity,facilitating timely and effective intervention,and is thus recommended for clinical use.

Comprehensive ecological risk assessment for heavy metal pollutions in three phases in rivers

Literature lacked in providing a comprehensive research on heavy metal detection in aquatic, biological and sedimentary states of rivers. The present study was imparted with all these three components of the river. Heavy metal toxicity or pollution index was used as a tool for ecological risk assessment by considering the single state studies conducted by many researchers. An intensive ecological risk assessment model was constructed and heavy metals were indicated as a serious threat to the environment. The model was applied to determining five toxic heavy metals in three states of the Songhua River. According to the ecological risk index, heavy metal pollution in three phases was categorized as aquatic〉biological〉sedimentary, while the overall descending order of heavy metal ecological risk index was as Cd〉Hg〉As〉Pb〉Cr. Cd and Hg were selected as the priority pollutants of Songhua River.

Comprehensive Assessment of Drought Resistance of Proso Millet Germplasm Resources in Shanxi

In order to clarify drought resistance of proso millet applied in field production in Shanxi, we identified its drought resistance during the whole growth period and measured nine traits, including plant height, panicle length, stem diameter, panicle weight, grain weight per spike, straw weight per plant, node numbers of main stem, 1 000-grain weight and effective panicles, under different treatments. Principal component analysis and stepwise regression analysis were used for comprehensive evaluation of drought resistance during the whole growth period and screening the drought index. The results showed that there were correlations among 9 phenotypic traits. The coefficient of variation of panicle weight and straw weight per plant sharply reduced under normal water supply and drought stress. Landrace ＂yellow millet＂ had the strongest drought resistance（D =0.87）, integrated drought D value and membership function value of yield had significant correlation（r =0.515 9, P〈0.05）. Panicle weight and straw weight per plant had significant impact on drought resistance and could be taken as comprehensive indexes of drought resistance identification in growth period.

A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension： a cross-sectional study

Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients （age 79.5 ＋ 6.7 years, male 63.8%） were recruited to the study. Comprehensive geriatric assessment （CGA）, including measurements about activity of daily living （ADL）, nutrition, cognition, depression, numbers of prescription medication and number of clinical diagnosis, was conducted to evaluate the physical and mental status of each participants. Fall risk was evaluated by Morse fall scale, Tinetti perform- ance oriented mobility assessment （POMA） and history of fall in the recent years. Participants were grouped into tertiles according to CGA score. Correlation between CGA and fall risk was analyzed through SPSS 18.0. Results Participants with higher CGA score were likely to be older, had a lower body mass index （BMI）, and a higher prevalence of cardiovascular disease, chronic obstructive pulmonary disease （COPD）, cerebrovascular disease and osteoarthropathia. Participants in higher tertile of CGA score got increased prevalence of fall risk than those in lower tertile （P 〈 0.01 T3 vs. T1, P 〈 0.01 T3 vs. T2）. Correlation analysis and regression analysis showed significant association between CGA and Morse fall scale （P 〈 0.001）, as well as CGA and POMA （P 〈 0.001）. Meanwhile, CGA components also showed co-relationships with increase fall risks. After adjusting age, BMI, benzodiazepine use, cardiovascular disease, cerebrovascular disease, COPD and osteoarthropathia, both history of fall in the recent year and rising Morse fall scale were significantly associated with ADL im- pairment （OR： 2.748, 95%CI： 1.598-4.725）, （OR： 3.310, 95%CI： 1.893-5.788）. Decreased Tinetti POMA score was associated with Mini-Mental State Examination （MMSE） （OR： 4.035, 95%CI： 2.100-7.751）, ADL （OR： 2.380, 95%CI： 1.357-4.175） and shortened MNA form （MNA-SF） impairment （OR： 2.692, 95%CI： 1.147-6.319）. Conclusions In elderly adults with hypertension, impaired physical and mental function is associated with increased fall risk. Further study is required to investigate possible mediators for the association and effec- tive interventions.

Spatial assessment for groundwater quality based on GIS and improved fuzzy comprehensive assessment with entropy weights

The objective of the research is to evaluate spatial groundwater quality based on improved fuzzy comprehensive assessment model with entropy weights(FCAEW)in geographical information system(GIS)environment.This paper explores the method of comprehensive evaluation of groundwater and sets up an evaluation model applying GIS and FCAEW.Groundwater samples were collected and analyzed from 29 wells in Zhenping County,China.Six parameters were chosen including chloride,sulfate,total hardness,nitrate,fluoride and color.Better spatial interpolation methods for evaluated parameters are found out and selected according to the minimum cross-validation errors from the interpolation methods.FCAEW model was carried out with the help of GIS which makes the evaluating process simpler and easier and more automatically,effectively,efficiently and intelligently.The result embodies the feasibility and effectiveness of FCAEW in GIS when compared with other comprehensive evaluation methods.

Value of a comprehensive geriatric assessment for predicting one-year outcomes in patients undergoing transcatheter aortic valve implantation: results from the CGA-TAVI multicentre registry

Background In a three-month report from the CGA-TAVI registry, we found the Multidimensional Prognostic Index (MPI) and Short Physical Performance Battery (SPPB) to be of value for predicting short-term outcomes in elderly patients undergoing transcatheter aortic valve implantation (TAVI). In the present analysis, we examined the association of these tools with outcomes up to one year post-TAVI. Methods CGA-TAVI is an international, observational registry of geriatric patients undergoing TAVI. Patients were assessed using the MPI and SPPB. Efficacy of baseline values and any postoperative change for predicting outcome were established using logistic regression. Kaplan- Meier analysis was carried out for each comprehensive geriatric assessment tool, with survival stratified by risk category. Results One year after TAVI, 14.1% of patients deceased, while 17.4% met the combined endpoint of death and/or non-fatal stroke, and 37.7% the combined endpoint of death and/or hospitalisation and/or non-fatal stroke. A high-risk MPI score was associated with an increased risk of all-cause mortality (aOR = 36.13, 95% CI: 2.77–470.78, P = 0.006) and death and/or non-fatal stroke (aOR = 10.10, 95% CI: 1.48–68.75, P = 0.018). No significant associations were found between a high-risk SPPB score and mortality or two main combined endpoints. In contrast to a worsening SPPB, an aggravating MPI score at three months post-TAVI was associated with an increased risk of death and/or non-fatal stoke at one year (aOR = 95.16, 95% CI: 3.41–2657.01). Conclusions The MPI showed value for predicting the likelihood of death and a combination of death and/or non-fatal stroke by one year after TAVI in elderly patients.

Comprehensive Assessment of Seawater Quality Based on an Improved Attribute Recognition Model

The attribute recognition model (ARM) has been widely used to make comprehensive assessment in many engineering fields, such as environment, ecology, and economy. However, large numbers of experiments indicate that the value of weight vector has no relativity to its initial value but depends on the data of Quality Standard and actual samples. In the present study, the ARM is enhanced with the technique of data driving, which means some more groups of data from the Quality Standard are selected with the uniform random method to make the calculation of weight values more rational and more scientific. This improved attribute recognition model (IARM) is applied to a real case of assessment on seawater quality. The given example shows that the IARM has the merits of being simple in principle, easy to operate, and capable of producing objective results, and is therefore of use in evaluation problems in marine environment science.

Gray comprehensive assessment and optimal selection of water consumption forecasting model

A comprehensive assessing method based on the principle of the gray system theory and gray relational grade analysis was put forward to optimize water consumption forecasting models. The method provides a better accuracy for the assessment and the optimal selection of the water consumption forecasting models. The results show that the forecasting model built on this comprehensive assessing method presents better self-adaptability and accuracy in forecasting.

Ability of Comprehensive Geriatric Assessment to Detect Frailty

Background and Aim of the Work: Frailty is a state of reduced physiological reserve associated with increased susceptibility to disability. It is associated with a high morbidity and mortality. This work assessed the ability of comprehensive geriatric assessment to detect frailty in elderly patients. Subjects and Methods: A total number of 104 elderly patients (above 60 years old) were included in this study and they were subjected to a comprehensive geriatric assessment (CGA) including: (history and full clinical examination, Mini mental status examination (MMSE), Geriatric depression scale (GDS), Activities of daily living (ADL), Instrumental activities of daily living (IADL). The patients were divided into frail and non-frail groups using Fried’s criteria as applied by Avila-Funes et al., 2008, each group included 52 patients. Results: There were no significant differences between the two groups regarding age gender or smoking habits. But there was higher percentage of ADL, IADL dependence in addition to higher incidence of depression and cognitive impairment among frail cases. Conclusion: Comprehensive geriatric assessment can be used to detect frailty and its associated impairment and comorbidities.

Fuzzy Comprehensive Assessment of Transnational Operation Environment for Chinese Oil Companies

A comprehensive method was developed to assess the transnational operation environment in host countries for Chinese oil companies. This method includes an assessment criterion system of the environment, which is to be scored by the experts. Analytical Hierarchy Process （AHP） and fuzzy mathematical methods were used to make evaluation and get the assessment result and ranking of three host countries.

Application of the Fuzzy Comprehensive Assessment Technique to Optimal Selection of Pipeline Design Alternative

s: Regarding the influencing factors in an optimal selection of pipeline design alternative as fuzzy variables with different weights, a fuzzy comprehensive assessment was applied to an optimal selection of the design alternative. Giving the Lanzhou-Chengdu pipeline as an example to explain the process, the result shows that this method is acceptable.

Comprehensive Assessment and Analysis of Water Environmental Quality in the Mainstream of the Liaohe River

[Objective] The study aims at evaluating the water environmental quality of the Liaohe River mainstream. [ Method] The water quality of two monitored sections in the mainstream of the Liaohe River from 2004 to 2010 was assessed by the fuzzy comprehensive appraisal combined with weighted average, and some practicable measures were put forward according to the assessment results. [ Result] From 2004 to 2010, the water quality of the Liaohe River mainstream varied from Grade II to III at Zhuershan section, and changed from Grade II to IV at Xing＇an section, becom- ing better on the whole. In addition, the major factor influencing the water quality is the small content of dissolved oxygen （DO） in the water body. Meanwhile, the pollution of the water body mainly results from the discharge of organic matter consuming oxygen largely, and ammonia nitrogen should be paid more attention to. [ Conclusion] The research could provide scientific references for the protection of water environment and its pollu- tion control in the mainstream of the Liaohe River.

Index system and methods for comprehensive assessment of cross-border power grid interconnection projects

With the global economy integration and progress in energy transformation,it has become a general trend to surpass national boundaries to achieve wider and optimal energy resource allocations.Consequently,there is a critical n eed to adopt scie ntific approaches in assessi ng cross-border power grid interconnection projects.First,con sidering the promotion of large-scale renewable energy resources and improvements in system adequacy,a comprehensive assessment index system,including costs,socio-economic benefits,environmental benefits,and technical benefits,is established in this study.Second,a synthetic assessment framework is proposed for cross-border power grid interconnection projects based on the index system comprising cost-benefit analysis,with market and network simulations,iterative methods for indicator weight evaluation,and technique for order preferenee by similarity to an ideal solution(TOPSIS)method for the project rankings.Fin ally,by assessi ng and comparing three cross-border projects betwee n Europe and Asia,the proposed index system and assessment framework have been proved to be effective and feasible;the results of this system can thus support investment decision-making related to such projects in the future.

Regional comprehensive assessment on environment-health of China

The aim of the study was to assess the environment-health development in different regions of China. 175 indicators, such as average life expectancy at birth, emission intensity of waste gas, GDP etc. were chosen to describe various aspects of the environment, health and development of China. Of all the indicators, life expectancy can sufficiently reflect health situation of population. Consequently, life expectancy was identified as key indicator, and 42 out of 175 indicators were selected for establishing the environment-health indicator framework with three grades of integrative indices to assess the development of environment-health of China. Based on the hierarchical relation between various grades of indices, the comprehensive environment-health index was calculated and contributed to classify the environment-health situation of 30 provinces, municipalities and autonomous regions in China which were divided into five grades by four predefined limits. Comprehensive assessment indicates that the environment-health situation of the eastern and coastal areas is superior to that of inland which is the western regions with underdeveloped economy and rigorous natural condition. Especially, the Qinghai-Tibet and Yunnan-Guizhou plateaus in southwestern China are most vulnerable in the environment and population health. These fit in with the pattern of national socio-economic development, which fully shows that socio-economic context plays a dominant role in the improvement of environment-health in China.

Comprehensive benefits assessment of the ecological management model in Hobq Desert of China

The Hobq Desert is the seventh largest desert in China. Since 1988, the effects of ecological management in Hobq Desert have been obvious and a typical desertification control model developed gradually, which is well known as the ＂Hobq model＂. It is important to evaluate the comprehensive benefits of the ＂Hobq model＂, but this has not been addressed in previous studies. Thus, we established an index system to comprehensively evaluate the benefits of the ＂Hobq model＂, using an analytic hierarchy process method from 1988 to 2013. The results show the following： ecological benefits of the ＂Hobq model＂ had a positive trend, but with fluctuations during 2008 and 2009; economic benefits increased by 74% and the maximum value occurred in 2013; and social benefits increased steadily, but with fluctuations in 2010 and 2011. The social benefits were higher than ecological and economic benefits in the same period. Trends in overall benefits of the ＂Hobq model＂ were similar to changes in ecological benefits, which increased each year.

Risk Assessment and Comprehensive Control of Insect and Wild Animal Vectors in the Prevalence of Related Equine Diseases in the Specific Equine Disease-free Zone of Guangzhou Asian Games

[ Objective] In order to construct the specific equine disease-free zone of of the Guangzhou Asian Games, to ensure that the equestrian events of Guangzhou Asian Games be smoothly held. [Methods] The species, quantities, distribution and seasonal variations of insects and wild animals in related zones were investigated from 2008 to 2010, and the collected samples of the insects and wild animals were tested in laboratory for related equine diseases. [Results] The investigations indicated that there were some mosquitoes, flies, horseflies, punkies, ticks, bats, wild birds and wild bears in equastrianism venue and peripheral regions of disease-free zone of the Guangzhou Asian Games, the laboratory results of Japa- nese encephalitis, vesicular stomatitis, Nipah virus disease, West Nile fever, and Trypanosomiasis evansi, were all negative. According to the in- vestigations and test results, the risk assessments of insect and wild animal vectors in the prevalence of related equine diseases were made to con- firm that the risk was relatively low or very low, and comprehensive prevention and control measures with prevention as major measures and insecti- cides application and environment managements as supplementary means were made on the basis of the risk assessment conclusions. [ Conclu- sions] This research has laid a solid foundation for the successful building of the first specific equine disease-free zone in our country, ensured the smooth holding of the 16th equastdan competition in Guangzhou Asian Games.