AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured intervi...AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field nonmydriatic retinal photography. RESULTS： Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10 y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12 mo, the number decreased to 210（47%） and 131（30%） separately. Most of the participants（95%） were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them（12%） however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47（0.29-0.74）, P〈0.001, education years ago, Adj. OR=0.56（0.33-0.96）, P=0.036]. The duration of disease also increasedthe likelihood of having undergone eye screening（Adj. OR=0.96, P〈0.05）. CONCLUSION： Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.展开更多
Background and Aims:Disease severity across the different diagnostic categories of metabolic dysfunction-associated fatty liver disease(MAFLD)remains elusive.This study assessed the fibrosis stages and features of MAF...Background and Aims:Disease severity across the different diagnostic categories of metabolic dysfunction-associated fatty liver disease(MAFLD)remains elusive.This study assessed the fibrosis stages and features of MAFLD between different items.We also aimed to investigate the associations between advanced fibrosis and risk factors.Methods:This multicenter cross-sectional study enrolled adults participating in liver disease screening in the community.Patients were stratified following MAFLD diagnostic criteria,to group A(395 patients)for type 2 diabetes,group B(1,818 patients)for body mass index(BMI)>23 kg/m^(2),and group C(44 patients)for BMI≤23kg/m^(2) with at least two metabolic factors.Advanced fibrosis was defined as a fibrosis-4 index>2.67.Results:Between 2009 and 2020,1,948 MAFLD patients were recruited,including 478 with concomitant liver diseases.Advanced fibrosis was observed in 125 patients.A significantly larger proportion of patients in group C(25.0%)than in group A(7.6%)and group B(5.8%)had advanced fibrosis (p<0.01).Logistic regression analysis found that hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfection(odds ratio[OR]:12.14,95%confidence interval[CI]:4.04-36.52;p<0.01),HCV infection(OR:7.87,95%CI:4.78-12.97;p<0.01),group C(OR:6.00,95%CI:2.53-14.22;p<0.01),and TC/LDL-C(OR:1.21,95%CI:1.06-1.38;p<0.01)were significant predictors of advanced fibrosis.Conclusions:A higher proportion of lean MAFLD patients with metabolic abnormalities had advanced fibrosis.HCV infection was significantly associated with advanced fibrosis.展开更多
With the increasing prevalence of mental disorders,regional mental health service systems face challenges including uneven resource distribution,inefficient referral pathways,and fragmented information.To address thes...With the increasing prevalence of mental disorders,regional mental health service systems face challenges including uneven resource distribution,inefficient referral pathways,and fragmented information.To address these issues,a platform-based bidirectional referral model centered on a municipal psychiatric specialty hospital was developed and implemented,linking community hospitals and county-level psychiatric departments.A unified regional mental health information platform was used to integrate patient data.Community hospitals conducted preliminary screening,county-level psychiatric departments performed referral assessment,and the municipal psychiatric specialty hospital made centralized evaluation and admission decisions.The implementation results demonstrated standardized screening processes,clearer referral pathways,reduced unnecessary hospitalizations,improved accuracy of patient admission,and enhanced mental health service capacity at the primary care level.This model contributes to optimizing mental health resource allocation and improving the efficiency of tiered mental health services.展开更多
基金Supported by the National Natural Science Foundation of China(No.81273159)Capital Medical Development Research Fund(No.2009-2034)
文摘AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field nonmydriatic retinal photography. RESULTS： Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10 y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12 mo, the number decreased to 210（47%） and 131（30%） separately. Most of the participants（95%） were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them（12%） however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47（0.29-0.74）, P〈0.001, education years ago, Adj. OR=0.56（0.33-0.96）, P=0.036]. The duration of disease also increasedthe likelihood of having undergone eye screening（Adj. OR=0.96, P〈0.05）. CONCLUSION： Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.
基金supported in part by grants from The Ministry of Science and Technology,Taiwan(MOST 110-2314-B-03-073-MY3)The Ministry of Health and Welfare,Taiwan(MOHW,112-TDU-B-221-124007)+1 种基金National Yang Ming Chiao Tung University-Kaohsiung Medical University Joint Research Project(NYCU-KMU-111-I001,NYCU-KMU-112-I001)Kaohsiung Medical University Hospital(KMUH SA10907,KMUH110-0R05).
文摘Background and Aims:Disease severity across the different diagnostic categories of metabolic dysfunction-associated fatty liver disease(MAFLD)remains elusive.This study assessed the fibrosis stages and features of MAFLD between different items.We also aimed to investigate the associations between advanced fibrosis and risk factors.Methods:This multicenter cross-sectional study enrolled adults participating in liver disease screening in the community.Patients were stratified following MAFLD diagnostic criteria,to group A(395 patients)for type 2 diabetes,group B(1,818 patients)for body mass index(BMI)>23 kg/m^(2),and group C(44 patients)for BMI≤23kg/m^(2) with at least two metabolic factors.Advanced fibrosis was defined as a fibrosis-4 index>2.67.Results:Between 2009 and 2020,1,948 MAFLD patients were recruited,including 478 with concomitant liver diseases.Advanced fibrosis was observed in 125 patients.A significantly larger proportion of patients in group C(25.0%)than in group A(7.6%)and group B(5.8%)had advanced fibrosis (p<0.01).Logistic regression analysis found that hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfection(odds ratio[OR]:12.14,95%confidence interval[CI]:4.04-36.52;p<0.01),HCV infection(OR:7.87,95%CI:4.78-12.97;p<0.01),group C(OR:6.00,95%CI:2.53-14.22;p<0.01),and TC/LDL-C(OR:1.21,95%CI:1.06-1.38;p<0.01)were significant predictors of advanced fibrosis.Conclusions:A higher proportion of lean MAFLD patients with metabolic abnormalities had advanced fibrosis.HCV infection was significantly associated with advanced fibrosis.
文摘With the increasing prevalence of mental disorders,regional mental health service systems face challenges including uneven resource distribution,inefficient referral pathways,and fragmented information.To address these issues,a platform-based bidirectional referral model centered on a municipal psychiatric specialty hospital was developed and implemented,linking community hospitals and county-level psychiatric departments.A unified regional mental health information platform was used to integrate patient data.Community hospitals conducted preliminary screening,county-level psychiatric departments performed referral assessment,and the municipal psychiatric specialty hospital made centralized evaluation and admission decisions.The implementation results demonstrated standardized screening processes,clearer referral pathways,reduced unnecessary hospitalizations,improved accuracy of patient admission,and enhanced mental health service capacity at the primary care level.This model contributes to optimizing mental health resource allocation and improving the efficiency of tiered mental health services.
