Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-09-01 Cooperative journals: 《中国全科医学》
Abstract： Falls are the important causes of morbidity and mortality in older adults. Although clinical staff have paid attention to the management of falls，adherence to fall interventions is not satisfactory，resulting in the high incidence of fall. Understanding the older adults' own perception of fall risk from their perspective may be the key to fall prevention，especially active fall prevention. In this paper，we reviewed the concept of fall risk perception，behavioral consequences and influencing factors of fall risk perception in older adults from the perspective of "the first person responsible for health"，and found that there are fewer studies on fall risk perception in older adults at home and abroad，the conceptual connotation still needs to be further explored. Subjective perceptions of fall risk in older adults can lead to different patterns of fall risk coping behaviors that influence fall risk. The influencing factors of fall risk perception mainly focus on the emotional psychology，physiological conditions，social culture，and physical environment，with the influencing process through subjective cognition. Empirical studies can be used to further validate the psychological cognitive mechanisms of fall risk perception in conjunction with the risk perception formation process in the future，in order to provide empirical evidence for proactive fall prevention.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-06-16 Cooperative journals: 《中国全科医学》
Abstract： Background Previous studies have shown that self-rated health would be used as a simple assessment indicator for frailty，and individuals with poor self-rated health status are at higher risk of frailty. However，the association between self-rated health and frailty may be different and the effectiveness of self-rated health in frailty assessment may vary in apathetic older adults. Objective To explore the moderating role of apathy in the association between self-rated health and frailty among community-dwelling older adults，so as to provide theoretical guidance for the application of the self-rated health in the assessment of frailty in apathetic older adults. Methods From November 2021 to March 2022，a total of 384 community dwelling older adults were selected as respondents by convenience sampling method，including 179 cases in Nanjing communities and 205 cases in Donghai Communities. Questionnaire surveys were conducted using the General Information Questionnaire，Fried Frailty Phenotyp（FFP），Geriatric Depression Scale（GDS-3），and the self-reported health（SRH）. Generalized linear model was used to analyze the association between self-rated health and frailty of community-dwelling older adults. The model 1 of the SPSS macro program process compiled by Hayes was used to analyze the moderating role of apathy on the association between the self-rated health and frailty，with simple slope analyze performed and simple slope graphs plotted. Results The median FFP and SRH item scores of 384 community-dwelling older adults were 1.00（2.00）and 4.00（1.00），respectively， with the detection rate of apathy of 55.5%（213/384）. The results of the generalized linear model showed that the relationship between the self-rated health and frailty of community-dwelling older adults was significant（b=0.310，P<0.001）. The results of the moderating effect test showed that apathy played a moderating role in the relationship between self-rated health status and frailty in community-dwelling older adults（b=0.355，t=3.074，P=0.002），and the results of simple slope analysis showed that the simple slope of the non-apathy group and apathy group was 0.100（t=1.209，P=0.228）and 0.455（t=5.206，P<0.001），respectively. Conclusion There is an association between self-rated health and frailty in community-dwelling older adults，and the application of the self-rated health can help community health workers assess frailty in older adults. Apathy plays a moderating role in the relationship between self-rated health and frailty. Compared with the non-apathetic older adults，the association between self-rated health and frailty was significant in apathetic older adults. Strengthening the self-rated health assessment of older adults is beneficial to the identification of their frailty.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
With the development of information technology, artificial intelligence shows great potentials for clinical diagnosis and treatment. Nevertheless, algorithmic bias in artificial intelligence can lead to problems such as unequal distribution of healthcare resources, which significantly affect patients’ health equity. Algorithmic bias is a technical manifestation of human bias, which is related to the process of artificial intelligence development, including data collection, model training and optimization as well as output application. Since healthcare providers have a direct impact on patients’ health, they should take measures to prevent algorithmic bias and related health equity. It is also important for healthcare providers to ensure the unbiasedness of health data, optimize the fairness of artificial intelligence, and enhance the transparency of its output application. In addition, healthcare providers also need to consider how to solve algorithmic bias and bias related health inequity in clinical practice in order to fully and properly protect patients' health equity. This paper reviews the causes and countermeasures of algorithmic bias in the health field to improve healthcare providers’ awareness and ability in identifying and addressing algorithmic bias, as well as provide empirical foundations for ensuring the health equity in the information age.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-03 Cooperative journals: 《中国全科医学》
Abstract：
Background Self-rated health is negatively related to frailty. The better the self-rated health (SRH) is, the lower the degree of frailty is. The relationship between the two conditions may be different in people suffering from apathy. Objective To explore the moderating effect of the apathy on the relationship between SRH and frailty among community-dwelling older adults. Methods A convenience sampling method was adopted. Fried Frailty Phenotype (FFP), Geriatric Depression Scale (GDS-3), Self-Rated Health (SRH), and demographic information were used to investigate the research question with 384 community-dwelling older adults. Results The strength of the relationship between SRH and frailty was moderated by apathy (B= -0.355，t= -3.074，P< 0.002), such that, apathy strengthened the predictive effect of SRH on frailty. Conclusion SRH is negatively related to frailty. Apathy plays an important positive role in strengthening the negative relationship between SRH and frailty among Chinese community-dwelling older adults.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-12-20 Cooperative journals: 《中国全科医学》
Abstract：
With the increasing aging population in China, older adults’ falls and fall-related injuries have gained increased attention, and preventive guidelines have also been developed and regularly updated. In 2022, The World Falls Guidelines Task Force assembled 96 experts from 39 countries issued the World Guidelines for Falls Prevention and Management for Older Adults. The guideline uses a person-centered approach by taking full account of the needs of older adults on the management of falls and the perceptions and experiences of caregivers and other stakeholders on preventing falls of older adults, as well as the utility of the guideline in various care settings and locations with limited resources. The guideline also incorporates the latest evidence on the use of e-health for fall prevention to provide new clinical recommendations on the screening, assessment, and management of risk for falls among community-dwelling older adults. It also promotes physical activity and falls prevention for all older adults. The current work offers an in-depth interpretation of guidelines and provides practical guidance to Chinese clinicians and community workers for prevention and management of falls in older adults.
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