青少年身体自我概念与参与体育锻炼的关系研究

目的试图通过实证性研究考查我国部分青少年的身体自我概念水平与体育锻炼情况的关系。方法以5所1379名中学生为被试,身体自我描述问卷(简称PSDQ)和自编的体育锻炼情况调查表为研究工具。结果男中学生身体自我概念中除了健康维度外,其他维度的得分均显著高于女生(P<0.01);体育锻炼的各指标,即锻炼年限等均可以在某种程度上由身体自我概念的运动能力维度来预测。结论青少年的身体自我概念存在性别差异;身体自我概念的各个维度及总分与体育锻炼情况之间存在很多显著相关。     

Multiple drug use by older people: exploring the health development and political economy perspectives

The use of multiple medications by a large number of older people provides grounds for concern in terms of quality of life as well as cost. We argue that problems faced by older people are being over-medicalized in a manner that palliates and obscures social causes such as loss of income, the falling away of social support and a discounted role in society. Primary health care is a policy model for the development of health services which offers a credible strategy for addressing clinical problems associated with growing old in ways that also contribute to recognizing and addressing social and structural problems that may be expressed in people's private troubles.     

中国中老年人失能状况公平性与影响因素

目的 分析中国50岁及以上中老年人失能状况和失能状况公平性,并探究中老年人失能状况不公平的主要影响因素。方法 利用全球老龄化与成人健康研究(Study on Global Ageing and Adult Health,SAGE)中国2007—2010年第一轮调查数据,计算集中指数和集中曲线,并对集中指数进行分解。结果 中国中老年人失能评估量表平均分为7.32,中老年男性平均分为6.37,女性平均分为8.21。中老年人失能状况集中指数为-0.190 9,中老年男性为-0.184 4,中老年女性为-0.196 1。对集中指数进行分解后,社会经济地位对中老年人失能状况不公平的贡献较高,包括经济水平、受教育程度和工作类型,贡献率分别为66.41%、16.45%和13.10%。与社会结构因素相比,中老年人吸烟、饮酒和身体活动情况等个人生活方式因素的贡献率较低。结论 中国存在中老年人失能状况不公平,较好的健康状况集中在经济水平较好的中老年人群中。中老年男性失能状况较女性更轻,且失能状况不公平程度更小。经济水平、受教育程度和工作类型是对中国中老年人失能状况不公平贡献率较高的主要因素,提示仅通过促进中老年人健康生活方式不能够有效减少失能状况在经济水平较好和较差的中老年人群中的差异。政府需要在重视促进中老年人健康的基础上,进一步加强和完善适宜的社会和医疗保障措施,将减少中老年人健康不公平作为政策重点,尤其应该向发展相对滞后、中老年人相对聚集的地区重点分配医疗卫生和其他相关社会资源,同时应该加大对中老年人健康和健康公平相关研究的支持,为积极应对人口老龄化和制定政策收集证据。     

青年人胃癌临床病理34例分析

目的　探讨青年人胃癌的临床病理特点。方法　回顾性分析 34例青年胃癌病人的临床表现、病理特点、治疗及预后 ,并与 4 0例中老年胃癌病人进行对比。结果　青年人胃癌与中老年人胃癌的临床表现相似 (P >0 .1) ,诊断常被延误 (P <0 .0 5)。其病理类型以未分化癌及低分化腺癌多见 ( 79.4 % ) ,手术切除率低( 4 1.2 % ) ,预后差 ( 5年生存率 8.8% ) ,与中老年组比较P均 <0 .0 1。结论　青年人胃癌病情进展快 ,转移早 ,改善预后的关键是早诊断 ,早治疗。     

降纤酶治疗青年人短暂性脑缺血发作的临床研究

目的 探讨降纤酶对青年人短暂性脑缺血（ＴＩＡ）发作的治疗效果。方法 将７２例患者随机分为两组。治疗组３７例,给予降纤酶静滴至ＴＩＡ发作终止或治疗达１周;对照组３５例,给予阿司匹林、尼莫地平、低分子右旋糖酐、脉络宁治疗２周。两组于治疗前、后分别采静脉血检测血浆纤维蛋白原、红细胞压积、全血粘度和血浆粘度的变化。结果 总有效率治疗组为９１．６６％,对照组为７７．１４％,２组间有显著性差异（Ｐ〈０．０１）     

上海市50岁及以上人群维生素D水平与握力的关联研究

目的 探讨上海市≥50岁人群维生素D水平与握力的关系。方法 数据来源于WHO全球老龄化与成人健康研究我国上海市2018-2019年数据,采用logistic回归模型分析维生素D水平与握力的关系,进一步按照性别、年龄及乳制品摄入情况进行分层;采用限制性立方样条曲线绘制维生素D水平与低握力的剂量-反应曲线。结果 共4 391人纳入研究,其中男性2 054人（46.8%）;年龄（67.02±8.81）岁;低握力1 421人（32.4%）;维生素D不足及缺乏分别为1 533人（34.9%）和401人（9.1%）。在调整相关混杂因素后,logistic回归分析结果显示,维生素D缺乏的人群发生低握力的风险更高（OR=1.41,95%CI：1.09~1.83）;在男性中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.67,95%CI：1.12~2.50）,而女性中两者之间无关联（OR=1.30,95%CI：0.97~1.74）;在60~69岁及≥80岁年龄组中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.57,95%CI：1.05~2.35;OR=2.40,95%CI：1.08~5.31）,在乳制品摄入<250 ml/d的人群中,调整相关混杂因素后,二者之间呈显著正相关（OR=1.57,95%CI：1.17~2.09）,而在乳制品摄入≥250 ml/d的人群中无明显关联。限制性立方条样图显示,低握力的发生风险可能随维生素D含量的上升而降低,但差异无统计学意义（P>0.05）。结论 维生素D水平与握力存在一定的关系,维生素D缺乏人群出现低握力的风险更高。     

Public participation and marginalized groups: the community development model

Objectives  To develop ways of reaching house-bound people and enabling them to give their views in planning and monitoring health and social care.
Strategy  HealthLINK – a project based in a community health council – explored ways of involving older house-bound people in the London Borough of Camden, in planning and monitoring health and social care using community development techniques.
Results  HealthLINK set up an infrastructure to enable house-bound people to have access to information and to enable them to give their views. This resulted in access for health and local authorities to the views of house-bound older people and increased the self esteem and quality of life of those who became involved.
Conclusions  Community development approaches that enable an infrastructure to be established may be an effective way of reaching marginalized communities. However, there are tensions in this approach between the different requirements for public involvement of statutory bodies and of users, and between representation of groups and listening to individual voices.     

大理地区正常人血清TT_3、TT_4水平

对比大理地区健康汉族人与白族人血清总三碘甲状腺原氨酸（ＴＴ３）、总甲状腺素（ＴＴ４）含量,建立本地区健康人ＴＴ３、ＴＴ４正常参考值。方法：对１００７例健康人（汉族６９１例,白族３１６例）进行血清ＴＴ３、ＴＴ４、ＲＩＡ检测。结果：健康汉族人与白族人血清ＴＴ３、ＴＴ４测定值相近,经统计学处理无显著性差异（Ｐ＞００５）;６０～７５岁年龄组的健康老年人血清ＴＴ３、ＴＴ４含量比其他年龄组明显降低（Ｐ＜００１）。结论：经检测得出的各年龄ＴＴ３、ＴＴ４水平,不论白族或汉族,男性或女性,均可作为正常参考值;６０岁以上健康老人ＴＴ３、ＴＴ４含量低于其他年龄是老年人正常的生理变化。     

Informal caregiving for frail older people at home and in long-term care institutions: who are the key supporters?

This paper describes the extent of the informal caregiving unit for older people who are physically or mentally frail living in private households or resident in long-term care institutions using cross-sectional analysis of survey data. A total of 1444 people aged 65 years or more registered with a general practitioner (GP) in four areas in England and, consenting to the study, were screened for mental or physical frailty. Of 1127 older subjects living at home 7% reported receiving no informal support, 15% had a paid supporter only and 78% nominated a key informal supporter who helped with defined activities of daily living of whom 650 (74%) were interviewed. Only 13% nominated more than one informal supporter. Key supporters were spouses (38%), daughters (30%), sons (9%), daughters-in-law (4%), other relatives (11%) and friends and neighbours (8%). Of 317 frail older people resident in long-term care institutions 175 (55%) received a main visitor at least once a week of whom 132 (75%) were interviewed. Main visitors were spouses (11%), daughters (36%), sons (23%), daughters-in-law (2%), other relatives (24%) and friends (4%). Qureshi & Walker's (1989) hierarchical, decision-making model for selecting informal caregivers was applied to the data and correctly identified 85% of key informal supporters and 79% of main visitors interviewed. This large-scale comprehensive survey of informal care for frail older people supports earlier small-scale localized studies highlighting the key role of spouses and daughters in the provision of informal support. Families of frail older people provide the support to maintain people at home.     

Problem solving,sense of coherence and instrumental ADL of elderly people with depression and normal control group

The purpose of this study was first, to explore the separate contribution and interaction between verbal and performance based problem solving and sense of coherence; and second, to examine the association of these variables with Instrumental Activities of Daily Living (IADL) function among elderly people with depression living in the commuinity and a normal control group. The participants included elders receiving ambulatory care for depression (n=31; mean age=73, SD=9.3); and normal elders (n=30; mean age=78, SD=5.8). Screening for general cognitive ability and level of depression was done using the Mini Mental Status Examination (MMSE) and the Geriatric Depression Scale (GDS). All participants underwent evaluation using the Large Allen Cognitive Level Test (LACL) (a measure of performance based problem solving); the Problem Solving Verbal Reaction to everyday problematic situations (PSVR); the Sense of Coherence questionnaire (SOC) and the Routine Task Inventory (RTI) (a measure of IADL from the cognitive perspective). Wilcoxon statistical analysis indicated highly significant differences between the two groups for all of the study variables. In the depressive group, significant correlations were found between the components of problem solving (LACL and PSVR) and IADL (r=0.70 and r=0.53), while the SOC did not correlate with IADL in either group. Results of ANCOVA controlling for LACL showed that it has a significant effect (F=13.63, p=0.001); however, beyond it verbal problem solving still has a significant effect on IADL (F=4.77, p=0.02), and SOC in interaction with verbal problem solving was significant (F=3.97, p=0.035). The findings suggest that depression in elderly people is associated with lower functioning in problem solving and IADL function, and lower sense of coherence; hence, attention to these factors should be integral to intervention with elderly people. However, it is recommended that further study be made of the relationships of variables found in this study with the current instruments, and also with additional tools because of confounding effects, in order to further support and validate the findings. As the sample size was small compared with the number of measures, it is important to replicate the study with larger groups to have more power. Copyright © 1999 Whurr Publishers Ltd.