BackgroundCommunity-based health education programs may be helpful in improving health outcomes in patients with chronic illnesses. This study aimed to evaluate community-based health education strategies in the management of hypertensive patients with low socioeconomic status in Dongguan City, China.MethodsThis was a randomized, non-blinded trial involving 360 hypertensive patients enrolled in the community health service centre of Liaobu Town, Dongguan City, China. Participants were randomized to receive one of the three community-based health education programs over 2 years: self-learning reading (Group 1), monthly regular didactic lecture (Group 2), monthly interactive education workshop (Group 3). Outcomes included the changes in the proportion of subjects with normalized blood pressure (BP), hypertension-related knowledge score, adherence to antihypertensive treatment, lifestyle, body mass index and serum lipids.ResultsAfter the 2-y intervention, the proportion of subjects with normalized BP increased significantly in Group 2 (from 41.2% to 63.2%, p<0.001), and increased more substantially in Group 3 (from 40.2% to 86.3%, p<0.001), but did not change significantly in Group 1. Improvements in hypertension-related knowledge score, adherence to regular use of medications, appropriate salt intake and regular physical activity were progressively greater from group 1 to group 2 to group 3. Group 3 had the largest reductions in body mass index and serum LDL cholesterol levels.ConclusionInteractive education workshops may be the most effective strategy in community-based health promotion education programs for hypertensive patients in improving patients’ knowledge on hypertension and alleviating clinical risk factors for preventing hypertension-related complications.

Background Multimorbidity is common among the middle-aged and elderly residents. And it is associated to the reduction of health-related quality of life (HRQoL), including physical and psychological dimensions. However, there are few studies that have paid attention to the HRQoL of residents with multimorbidity in China. Therefore, this study aims to investigate the relationships between different multimorbidity patterns and HRQoL among middle-aged and elderly adults in China. Methods Based on a cross-sectional survey, the information regarding 18,137 adults, who were at least 45 years of age, was collected through interviews. Self-perceived HRQoL was assessed with the EQ-5D-3 L instrument, and the EQ-5D-3 L index score was calculated using the Chinese EQ-5D-3 L value set. The Tobit regression was used to explore the impacts of multimorbidity groups on HRQoL. Results Of 18,137 respondents, more than a fifth (3773,20.8%) of people had multimorbidity. Mean (SD) of EQ-5D index and VAS values were 0.95(0.14) and 76.02(13.66), respectively. Significant correlations were found between a lower HRQoL and increasing numbers of chronic conditions ( P < 0.001). Most of chronic diseases co-occurred frequently, and the association between hypertension and diabetes mellitus was the strongest (adjusted OR = 3.82). The most prevalent disease is hypertension (5052,27.9%), and the most prevalent chronic diseases pair is hypertension and diabetes mellitus (841,4.6%). Among those chronic diseases with high prevalence, the effects on HRQoL ranged from chronic pain to hypertension (adjust b = − 0.036 to − 0.008). In the common multimorbidity patterns, co-occurrence of chronic pain and bone disease (adjust b = − 0.039) had the greatest impact on HRQoL. Conclusions The HRQoL of middle-aged and elderly adults declines by multimorbidity. More attention should be paid to the HRQoL of residents with multimorbidity in China. The effect of different multimorbidity patterns on HRQoL is not simply added by two diseases, but changes by the different combination. Identifying different multimorbidity patterns of residents can provide more targeted measures to improve the HRQoL.

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The swelling and solvation of 100−200 nm thin films of a diblock copolymer consisting of a short poly(methyl methacrylate) (PMMA) block and a long poly(N-isopropylacrylamide) (PNIPAM) block are investigated in mixed water/methanol vapors. The processes are followed in real time using spectral reflectance (SR), time-offlight neutron reflectometry (ToF-NR), and Fourier transform infrared (FT-IR) spectroscopy, applying two neutron scattering contrast variation sequences. After hydration in pure water vapor, the vapor composition (relative to a flow rate of 1 L/ min ≙ 100%) is changed to 70% water (D 2 O/H 2 O) and 30% methanol (CH 3 OH/ CD 3 OH). Upon the mixed vapor stimulus, a two-step response is found, in which an initially enhanced swelling of the films is followed by a contraction. Differences in the solvent exchange kinetics found in ToF-NR experiments coincide with characteristic changes in the FT-IR spectra. While the initially enhanced swelling of the films is driven by the absorption of methanol, the film contraction is related to the release of both solvents, with almost no further change in solvent composition. In analogy to the coil-to-globule transition encountered in the polymer solution, these film response characteristics are attributed to the cononsolvency behavior of PNIPAM in water/methanol mixtures.