Disease In Mainland China Research Articles

The risk factor assessment of the spread of foot-and-mouth disease in mainland China

In China, foot-and-mouth disease (FMD) serotype O remains prevalent, and its main host is pigs. Infected but undiscovered pigs can carry foot-and-mouth disease virus (FMDV) for a longtime. And, the virus can spread among farms through pig trade. Although individual vaccination at least 2 times a year and monthly monitoring disease and culling all individual in same group for pigs are adopted vigorously in China, the epidemic remains prevalent. Therefore, in this paper, based on these propagation characteristics and control measures of the epidemic in China, we take the pig farms as research individuals, the trade among farms as transmission routes to establish a dynamic model with nonlinear incidence. In addition, we use this model to assess the impact of trade and transport of pigs among farms on the spread of foot-and-mouth disease virus (FMDV), and to assess the effect of the immunization, monitoring and culling adopted presently in China on the control of the epidemic. By the dynamical analysis of the model, it is found that there will appear backward branching under some conditions, which means that there are two spreading thresholds for the disease, and the disease development trend is also related to the current epidemic situation. Besides, we give the threshold conditions of key parameters to control the spread of FMD. By carrying out data fitting and parameter estimation, we confirm the model rationality, and give four evaluation indexes: the basic reproduction number R0 of FMD serotype O in China, the value of the infected farms at the equilibria, annual probability of a susceptible farm being infected and annual transmission intensity of an infected farm. By carrying out the sensitivity analysis of key parameters on four evaluation indexes, the effect of parameters on the spread of the disease can be intuitively observed. All these can provide a theoretical basis for understanding of the trading-based transmission mechanism, control and prevention of foot-and-mouth disease in pigs in China.

The prevalence and severity of periodontal disease in Mainland China: Data from the Fourth National Oral Health Survey (2015–2016)

To evaluate periodontal conditions in adults in mainland China based on data from the 4th National Oral Health Survey. Data of adult subjects (35- to 44-year-old group [N=4409], 55- to 64-year-old group [N=4622], and 65- to 74-year-old group [N=4428]) were analysed. Demographic, socio-economic, personal habit, dental history, and health attitude data were obtained using a questionnaire. Periodontal condition was assessed using the standardized case definitions of the 2018 classification scheme. A multivariate analysis was performed to investigate the relationship between periodontitis severity and age, smoking status, gender, and region using generalized additive models after adjusting for confounders. The frequency of subjects with periodontitis was 52.8%, 69.3%, and 64.6% in the three age groups, respectively. The frequency of subjects with severe periodontitis (stage III or IV) was 10.6%, 37.3%, and 43.5% in the three age groups, respectively. The severity of periodontal disease was positively associated with age. Current and former smokers exhibited significantly greater disease severity than non-smokers after adjustment for confounders. No significant difference of severity was found between males and females. Within the limitations of the study, the prevalence of periodontitis is very high among adults in mainland China. Periodontal status is associated with age and smoking status.

Economic Loss of Pine Wood Nematode Disease in Mainland China from 1998 to 2017

The occurrence and prevalence of pine wood nematode disease has had a great impact on China’s forestry production and ecological environment, but the quantitative evaluation of the economic losses of this biological disease is lacking from a macro-geographic scale and long-term series perspective. This study establishes a pine wood nematode disease economic loss evaluation index system, covering the loss of natural ecology, landscape aesthetics and economic production, and quantitatively evaluates the economic losses of pine wood nematode disease in mainland China at a provincial level from 1998 to 2017. The results show that the economic losses of the pine wood nematode disease in China showed a fluctuant rising trend from 1998, since 2013, it has entered a full-scale outbreak phase, and since 2015, the economic loss has increased significantly, with a growth rate higher than 40%. The average annual total economic loss is CNY 7.17 billion, of which the direct economic losses is CNY 1.53 billion, and the indirect economic losses is CNY 5.64 billion. The loss of forest material resources, the expenditure of ineffective forest management expenditure and prevention and control expenditure were CNY 817 million, CNY 649 million, and CNY 67 million, respectively. Regulate service value loss, support service value loss and cultural service loss are CNY 3.95 billion, CNY 1.41 billion, CNY 276 million, respectively. East China and South China suffered the most due to pine wood nematode disease, and the economic loss of these regions accounted for 79.9% of the total national economic losses. Among them, Zhejiang Province, Guangdong Province and Jiangsu Province lost CNY 2.14 billion, CNY 1.81 billion, and CNY 1.22 billion, respectively, accounting for 26.8%, 22.7% and 15.3% of the total national economic loss.

Diet, nutrition and chronic disease in Mainland China

In the recent 3 decades, along with the rapid development of national economy, dietary pattern and lifestyle have undergone significant changes in Mainland China. At the same time, the major causes of disease and death in Mainland China have shifted from predominantly infectious disease and diet-related deficiency diseases to overweight/obesity and other non-communicable diseases, including hypertension, stroke, coronary heart disease, diabetes, cancers, etc. The characteristics of the dietary change are the decrease of cereal and vegetable consumption and the increase of animal foods and oil/fat consumption; although the average Chinese dietary pattern remains a plant food based diet. These dietary changes, in combination with the decrease of physical activity (sedentary life), continuous increase of tobacco and alcohol consumption have led to the rapid increase of non-communicable diseases (NCDs). The overall contribution of NCDs death to the total death of Chinese people is around 80%. Current evidences have provided enough scientific basis for placing NCDs prevention and control as the high priority in public health; although further studies on the interactions between human genome and lifestyle factors are important for improving the effectiveness of prevention and control strategies.

The role of genetics in Parkinson's disease: a large cohort study in Chinese mainland population.

This study aimed to determine the mutational spectrum of familial Parkinson's disease and sporadic early-onset Parkinson's disease (sEOPD) in a mainland Chinese population and the clinical features of mutation carriers. We performed multiplex ligation-dependent probe amplification assays and whole-exome sequencing for 1676 unrelated patients with Parkinson's disease in a mainland Chinese population, including 192 probands from families with autosomal-recessive Parkinson's disease, 242 probands from families with autosomal-dominant Parkinson's disease, and 1242 sEOPD patients (age at onset ≤ 50). According to standards and guidelines from the American College of Medical Genetics and Genomics, pathogenic/likely pathogenic variants in 23 known Parkinson's disease-associated genes occurred more frequently in the autosomal-recessive Parkinson's disease cohort (65 of 192, 33.85%) than in the autosomal-dominant Parkinson's disease cohort (10 of 242, 4.13%) and the sEOPD cohort (57 of 1242, 4.59%), which leads to an overall molecular diagnostic yield of 7.88% (132 of 1676). We found that PRKN was the most frequently mutated gene (n = 83, 4.95%) and present the first evidence of an SNCA duplication and LRRK2 p.N1437D variant in mainland China. In addition, several novel pathogenic/likely pathogenic variants including LRRK2 (p.V1447M and p.Y1645S), ATP13A2 (p.R735X and p.A819D), FBXO7 (p.G67E), LRP10 (c.322dupC/p.G109Rfs*51) and TMEM230 (c.429delT/p.P144Qfs*2) were identified in our cohort. Furthermore, the age at onset of the 132 probands with genetic diagnoses (median, 31.5 years) was about 14.5 years earlier than that of patients without molecular diagnoses (i.e. non-carriers, median 46.0 years). Specifically, the age at onset of Parkinson's disease patients with pathogenic/likely pathogenic variants in ATP13A2, PLA2G6, PRKN, or PINK1 was significantly lower than that of non-carriers, while the age at onset of carriers with other gene pathogenic/likely pathogenic variants was similar to that of non-carriers. The clinical spectrum of Parkinson's disease-associated gene carriers in this mainland Chinese population was similar to that of other populations. We also detected 61 probands with GBA possibly pathogenic variants (3.64%) and 59 probands with GBA p.L444P (3.52%). These results shed insight into the genetic spectrum and clinical manifestations of Parkinson's disease in mainland China and expand the existing repertoire of pathogenic or likely pathogenic variants involved in known Parkinson's disease-associated genes. Our data highlight the importance of genetic testing in Parkinson's disease patients with age at onset < 40 years, especially in those from families with a recessive inheritance pattern, who may benefit from early diagnosis and treatment.

The spatiotemporal distribution of human brucellosis in mainland China from 2007-2016

BackgroundDespite the considerable efforts made to address the issue of brucellosis worldwide, its prevalence in dairy products continues to be difficult to estimate and represents a key public health issue around the world today. The aim of the present study was to better understand the epidemiology of this disease in mainland China. We set out to investigate the yearly spatial distribution and possible hotspots of the disease.MethodsHuman brucellosis data from mainland China between 2007 and 2016 were collected from the China Information System for Disease Control and Prevention. A geographic information system ArcGIS10.3 (ESRI, Redlands) was used to identify potential changes in the spatial and temporal distribution of human brucellosis in mainland China during the study period. These distributions were evaluated using three-dimensional trend analysis and spatial autocorrelation analyse. A gravity-center was used to analyse the migration track of human brucellosis.ResultsA total of 399,578 cases of human brucellosis were reported during the 10-year study period. The monthly incidence of brucellosis in China demonstrates clear seasonality. Spring and summer are the peak seasons, while May is the peak month for brucellosis. Three-dimensional trend analysis suggests that brucellosis is on the rise from south to north, and that the epidemic situation in northern China is more severe. Between 2007 and 2016, the overall migration distance of the brucellosis incidence gravity-center was 906.43 km, and the direction was southwest. However, the overall gravity center of brucellosis was still in the northern part of China. In the global autocorrelation analysis, brucellosis in China demonstrated a non-random distribution between 2013 and 2014, with spatial autocorrelation (Z > 1.96, P < 0.05) and a clustering trend, while no clustering trend was found from 2007 to 2012 or from 2015 to 2016. In the local autocorrelation analysis, a Low-Low cluster phenomenon was found in the south of China in 2013 and 2014.ConclusionHuman brucellosis remains a widespread challenge, particularly in northern China. The hotspots highlight potential high-risk areas which may require special plans and resources for monitoring and controlling the disease.

Positive association between soil arsenic concentration and mortality from alzheimer’s disease in mainland China

ObjectivesThe current study was designed to investigate the relationship between the soil arsenic (As) concentration and the mortality from Alzheimer’s disease (AD) in mainland China. Study designEcological study. MethodsTwenty-two provinces and 3 municipal districts in mainland China were included in this study. The As concentrations in soil in 1990 was obtained from the China State Environmental Protection Bureau; the data on annual mortality of AD from 1991 to 2000 were obtained from the National Death Cause Surveillance Database of China. Using these data, we calculated the spearman correlation coefficient between soil As concentration and AD mortality, and the relative risk (RR) between soil As levels and AD mortality by quartile-dividing study groups. ResultsThe spearman correlation coefficient between As concentration and AD mortality was 0.552 (p = 0.004), 0.616 (p = 0.001) and 0.622 (p = 0.001) in the A soil As (eluvial horizon), the C soil As (parent material horizon), and the Total soil As (A soil As + C soil As), respectively. When the A soil As concentration was over 9.05 mg/kg, 10.40 mg/kg and 13.10 mg/kg, the relative risk was 0.835 (95 % CI: 0.832, 0.838), 1.969 (95 %CI: 1.955, 1.982), and 2.939 (95 % CI: 2.920, 2.958), respectively; when the C soil As reached 9.45 mg/kg, 11.10 mg/kg and 13.55 mg/kg, the relative risk was 4.349 (95 % CI: 4.303, 4.396), 6.108 (95 % CI: 6.044, 6.172), and 9.125 (95 %CI: 9.033, 9.219), respectively. No correlation was found between lead, cadmium, and mercury concentration in the soil and AD mortality. ConclusionThere was an apparent soil As concentration dependent increase in AD mortality. Results of this study may provide evidence for a possible causal linkage between arsenic exposure and the death risk from AD.

Application of palliative care in chronic diseases of advanced age

The prevention and treatment of chronic diseases has been gradually paid attention to by public health, and palliative care for patients with chronic diseases has become the main focus. The research on palliative care in China started late, so the palliative care for patients with chronic diseases is rarely mentioned. This article describes the development process and current situation of palliative care for chronic diseases of the elderly at home and abroad, points out the reasons why the development of palliative care for chronic diseases is slow in mainland China, and proposes some suggestions for the development of palliative care for chronic diseases in mainland China according to the obstacles and foreign countries. Key words: Palliative care; Advanced age; Chronic diseases

The Negative Emotions Due to Chronic Illness Screening Test (NECIS): Construct Validity in Patients with Coronary Artery Disease in Mainland China.

ObjectivePatients with coronary artery disease (CAD) are susceptible to the negative emotion and its adverse influence on the disease prognosis. It is of great necessity to have a simple measurement to timely assess negative emotions in patients with CAD. The Negative Emotions due to Chronic Illness Screening Test (NECIS) is a newly developed tool to measure negative emotions. However, the construct validity has not been established yet. Therefore, the purpose of this study was to test the construct validity of the NECIS in individuals with CAD in mainland China.MethodsThe tool was administered in a convenience sample of 376 patients with CAD hospitalized in three general hospitals in Wuhan City, China. Construct validity was evaluated through factorial validity, convergent validity and discriminant validity. Additionally, the assumed relationship between negative emotions with other associated variables (perceived control and perceived social support) was tested to provide additional evidence of the construct validity of the NECIS.ResultsExploratory factor analysis and confirmatory factor analysis established and confirmed a two-factorial structure of the NECIS. Convergent validity and discriminant validity of the NECIS were proven to be adequate. Two hypotheses regarding the relationship between negative emotions and associated variables (perceived control and perceived social support) were confirmed, which supported the satisfactory construct validity of the NECIS.ConclusionThe NECIS had sound construct validity when applied to patients with CAD in mainland China. This study added new knowledge regarding the construct validity of the NECIS, which supported its psychometric properties for future use.

Mortality trends of liver diseases in mainland China over three decades: an age-period-cohort analysis

ObjectiveTo analyse mortality trends of liver diseases in China over the past 30 years.DesignAge-period-cohort analyses were applied to liver diseases data obtained from the Chinese Health Statistics Annual Report (1987–2001)...

Identification ofColletotrichum siamensecausing litchi pepper spot disease in mainland China

Litchi (Litchi chinensis) pepper spot disease results in black spotting symptoms on litchi fruits. This disease was first observed on litchi cultivar Guiwei, in Guangzhou, China, in 2009, and then found widespread in other litchi‐growing regions of China.Colletotrichumisolates were consistently recovered from typical black spot lesions of diseased fruits with frequency ranging from 83% to 100%. Three representativeColletotrichumisolates from Maoming, Guangzhou and Shenzhen were selected for identification and pathogenicity testing in the field. Based on morphology and phylogenetic analysis using the ribosomal internal transcribed spacer region (ITS), glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH), calmodulin (CAL), actin (ACT), β‐tubulin (TUB2) and glutamine synthetase (GS) gene sequences, the three isolates were identified asC. siamense. In the pathogenicity experiments, typical symptoms appeared on the inoculated litchi fruits, including black spots and green patches around these black spots. These symptoms were consistent with the symptoms originally observed in the field.Colletotrichum siamensewas successfully reisolated from the typical black spot lesions of the inoculated litchi fruits. To the authors' knowledge, this is the first report on characterization ofC. siamenseas the causal agent of litchi pepper spot disease in mainland China by successful inoculation on fruits under field conditions.

Clinical and Molecular Features of Chronic Granulomatous Disease in Mainland China and a XL-CGD Female Infant Patient After Prenatal Diagnosis.

Chronic granulomatous disease (CGD) is the most common phagocyte defect disease. Here, we describe 114 CGD patients in our center and report a rare female infant with XL-CGD to provide a better understanding of diagnosis, treatment, and prenatal diagnosis of CGD. Patients were diagnosed by DHR-1,2,3 flow cytometry assays and gene analysis. X chromosome inactivation analysis and gp91phox protein test were used for a female infant with XL-CGD. XL-CGD accounts for the majority of cases in China and results in higher susceptibility to some infections than AR-CGD. The DHR assay can help diagnose CGD quickly, and atypical results should be combined with clinical manifestations, genetic analysis, and regular follow-up. For prenatal diagnosis, both gDNA and cDNA genotypes of amniotic fluid cells should be identified, and cord blood DHR assays should be performed to identify female XL-CGD patients.

Potential influential factors on incidence and prevalence of inflammatory bowel disease in mainland China.

The incidence of inflammatory bowel disease (IBD) has increased annually in newly industrialized countries. In mainland China, there is also a trend of increasing incidence and prevalence of IBD. Epidemiological studies have shown that the incidence of IBD in mainland China is higher in the south and lower in the north. However, the existing research results are affected by the factor of floating population. Some socioeconomic factors also seem to play a role in the rising trend of IBD incidence and prevalence. These underlying factors provide opportunities and challenges for our IBD epidemiological studies over the next decade.

Current Status of the Management of Mendelian Susceptibility to Mycobacterial Disease in Mainland China.

Although many studies have investigated Mendelian susceptibility to mycobacterial disease (MSMD) worldwide, there is no report of the long-term clinical management and prognosis for MSMD in China. This is a cohort study from January 2000 to June 2018. Three hundred and twenty-four patients with bacillus Calmette-Guérin (BCG) infection were diagnosed during this period, and those with MSMD diagnosed by genetic and functional experiments were enrolled in the study. The clinical and genetic characteristics and management of these MSMD patients were summarized. Thirty patients diagnosed with MSMD were followed up. The age at the follow-up end point ranged from 5 to 173months. Among the patients, IL12RB1 mutations were identified in 22, IFNGR1 mutations in 5, STAT1 mutations in 2, and IFNGR2 mutation in 1. The medium age at onset was 3months. BCG infection involved multiple organs, including regional infection (8/30; 26.7%) or distant or disseminated infection (22/30; 73.3%). Ten percent (30/324) of patients with BCG infection had a confirmed MSMD diagnosis. Protein expression of IL12RB1 or IFNGR1 was decreased in all patients with IL12RB1 or IFNGR1 mutation, respectively, as indicated by flow cytometry. In addition, 77.8% of patients received rhIFN-γ treatment, which can improve the prognosis of patients with IL12RB1 deficiency. Two patients received stem cell transplantation. Twenty-five patients remained alive at the time of publication. MSMD is an important cause of BCG infection. Flow cytometric detection of IL12RB1 and IFNGR1 expression is very useful for rapid MSMD diagnosis. rhIFN-γ therapy is effective in patients with MSMD, particularly improving prognosis in those with IL12RB1 deficiency.

Factors Associated With Dyskinesia in Parkinson's Disease in Mainland China.

Background and Objectives: Studies examining the risk factors for dyskinesia in Parkinson's disease (PD) have been inconsistent, and racial differences exist. Since there have been no systematic studies of the characteristics of dyskinesia in the Mainland Chinese population, we sought to elucidate the risk factors for dyskinesia.Methods: A total of 1974 PD patients from Mainland China were systematically investigated by univariable and multivariable analyses. PD patients with and without dyskinesia were stratified into 4 groups according to levodopa equivalent daily dose (LEDD) and analyzed by a Cox proportional hazards model. A longitudinal study of 87 patients with dyskinesia was classified into 3 groups according to the duration from onset of PD to the initiation of levodopa, and comparisons among groups were analyzed by the Mann-Whitney test.Results: Early age of onset, long disease duration, being female, high LEDD, low UPDRS III scores (ON-state) and high Hoehn-Yahr stage (ON-state) were predictors of dyskinesia. Dyskinesia was levodopa dosage-dependent, and the incidence increased remarkably when LEDD exceeded 300 mg/d (p < 0.05). The emergence of dyskinesia had no association with the initiation time of levodopa, and if the latter was more than 4 years, the duration of time on chronic levodopa free of motor complications was significantly shortened.Conclusions: We found risk factors for the prediction of dyskinesia. Our data shows that physicians should be cautious if the LEDD exceeds 300 mg/d. The development of dyskinesia was not correlated with the time of levodopa initiation.

A multi-group model for estimating the transmission rate of hand, foot and mouth disease in mainland China.

In order to access the influence of different age groups on the spread of hand, foot and mouth disease (HFMD), we established the multi-group model with migration following the epidemiology of HFMD. The basic reproduction number of the HFMD epidemic model was calculated by the next generation operator method. According to China's national surveillance data on HFMD, we fitted the model parameters and estimated the transmission rates among different age groups. Besides, we carried out sensitivity analysis for the basic reproduction number to find some valuable regulatory measures. Our findings showed that the children under three years of age were indeed at high risk and adult group who had more contacts with children had a crucial influence on the spread of HFMD.

Assessing the spread of foot and mouth disease in mainland China by dynamical switching model

In mainland China, there are three prevalent serotypes of foot and mouth disease virus (FMDV) and they circulate in different susceptible animals, which respond to viral infection in various ways and present different prevalent features. Although powerful control measures are carried on regularly, the epidemic are still prevalent in livestock. Therefore it is essential to assess the disease trends of foot and mouth disease (FMD) in domestic animals in mainland China. The participation of contaminated environment in the transmission dynamics has been confirmed in laboratory research and it can alter the conditions for FMDV invasion and persistence. So environment transmission plays a key role in disease spreading process. In this paper, we establish a dynamical switching model with environment transmission to investigate the relevant internal force mechanism with respect to the threshold switching, effect of saturation of the quantity of FMDV in environment, and prevalent characteristics of the disease in mainland China. Through the dynamical analysis of the model, we understand that under different conditions, there may appear coexistence of one, two, three or even four steady states, and bistability might occur, showing that the development trend of epidemic not only depends on the model parameters, but also is associated with the initial condition. We further study the influence of key parameters on the dynamical behavior and classify the parameter space into several regions with different composition patterns. Applying the model to assess the development trend of FMD in livestock in mainland China, we find that under certain conditions, some of the serotypes persists and some may disappear, thus we can provide some suggestions for disease control of prevailing serotype.

Medication-related risk factors associated with health-related quality of life among community-dwelling elderly in China.

BackgroundPrevious studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ.MethodsThe study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression.ResultsA total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life.ConclusionPatient’s internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.

Chinese translation and psychometric testing of the cardiac self-efficacy scale in patients with coronary heart disease in mainland China

BackgroundA person’s self-efficacy plays a critical role during the chronic management process of a health condition. Assessment of self-efficacy for patients with heart diseases is essential for healthcare professionals to provide tailored interventions to help patient to manage the disease.ObjectiveTo translate and test the psychometric properties of the Chinese version of Cardiac Self-efficacy Scale (C-CSES) as a disease-specific instrument for patients with coronary heart disease (CHD) in mainland China.MethodsThe original English version of the CSES was translated into Chinese using a forward-backward translation approach. A convenience sample consisting of 224 Chinese patients with CHD were recruited from a university-affiliated hospital in Shiyan, China. The C-CSES and the General Self-efficacy Scale (GSES) were used in this study. The factor structure, convergent and discriminative validities, and internal consistency of the C-CSES were evaluated.ResultsThe confirmatory factor analysis (CFA) supported a three-factor high-order structure of the C-CSES with model fit indexes (RMSEA = 0.084, CFI = 0.954, NNFI = 0.927, IFI = 0.954 and χ 2 /df = 2.572). The C-CSES has good internal consistency with a Cronbach’s alpha of 0.926. The convergent validity of the C-CSES was established with significantly moderate correlations between the C-CSES and the Chinese version of the GSES (p < 0.001). The C-CSES has also shown good discriminative validity with significant differences of cardiac self-efficacy being found between patients with and without comorbidities of hypertension, diabetes, or heart failure.ConclusionThe empirical data supported that the C-CSES is a valid and reliable disease-specific instrument for assessing the self-efficacy of Chinese patients with CHD.

Drug-related problems among community-dwelling older adults in mainland China

Background Little is known about the extent of drug-related problems (DRPs) in community-dwelling older adult patients with chronic diseases in mainland China. Setting A medication therapy review service at a community health center in Chongqing, China. Objective To identify and categorize DRPs along with pharmacists' recommendations in addressing the DRPs identified. Method The study was conducted between May 2015 and July 2016. A total of 102 community-dwelling older adults were included. MTR was carried out by clinical pharmacists. DRPs and pharmacotherapy recommendations were recorded and analyzed. Main outcome measure The number of drug-related problems and main problem categories. Results The average age of patients was 69.4years. Patients took an average of 6.3 medications. A total of 489 DRPs were identified (mean of 4.8 per patient). The most common category was under-treated (27.8%) followed by over- or under-dose (18.8%) and monitoring (17.8%). The number of medications taken was the significant associated factor for DRPs. Pharmacists made 526 recommendations to address the DRPs (mean of 1.1 recommendations per DRP). Primary care providers accepted 68.1% of these recommendations, and implemented 60.9% of them. Conclusion The prevalence of DRPs among studied patient population was high. Pharmacists may play a vital role in addressing the DRPs and optimize pharmacotherapy through MTR service located in community health centers.