Determinants and Consequences of Adolescent Fatherhood: A Longitudinal Study in Ethiopia,India, Peru,and Vietnam

PurposeAdolescent parenthood is a major challenge in low- and middle-income countries (LMICs). However, the vast majority of the evidence has focused on adolescent motherhood. Little is known about adolescent fatherhood in LMICs. The aim of this study was to examine the determinants of early fatherhood and its consequences on a range of outcomes among adolescent males.MethodsThis study used three waves of longitudinal data from the multicountry Young Lives cohort study, specifically following a sample of 1,779 adolescent boys at ages 15, 19, and 22 years in Ethiopia, India, Peru, and Vietnam. Individual fixed effects models were conducted to investigate the sociodemographic determinants of adolescent fatherhood and the consequences of adolescent fatherhood on males' education, health, psychosocial well-being, and time use outcomes.ResultsThe results indicated that lower educational attainment, absence of the adolescent's mother and father from the home, larger household size, and poverty increased the likelihood of becoming an adolescent father by age 22 years. The results revealed that becoming an adolescent father was associated with a higher likelihood of school dropout, being overweight, smoking, greater internalizing problems, and less time spent on leisure activities and more time spent on caregiving responsibilities.ConclusionsHighlighting the experiences of young men as adolescent parents in LMICs, findings underscore the importance of prevention strategies to delay early parenthood for adolescent boys and multicomponent interventions to support young fathers and their unique health, socioeconomic, psychosocial, and behavioral needs.     

中青年缺血性脑卒中患者与健康人群生活行为习惯及基因多态性比较研究

目的 比较中青年缺血性脑卒中患者与健康人群生活行为习惯及基因多态性。方法 以2021年1—12月某医院收治的中青年缺血性脑卒中患者617例作为病例组,按照性别、年龄1∶1比例匹配同期医院进行体检健康者617例作为健康对照组,比较中青年缺血性脑卒中患者与健康人群生活行为习惯及基因多态性的差异,生活行为习惯包括控制体重、吸烟、饮酒、睡眠时间、体育锻炼、饮食健康,基因多态性采用聚合酶链反应（PCR）技术和分子杂交技术检测纤维蛋白原（FGB）G（-455）A、内皮细胞-白细胞黏附分子（ELAM）ser128arg、细胞黏附分子-1（ICAM1）gly214arg、肿瘤坏死因子α（TNFα）G（-308）A、肿瘤坏死因子β（TNFβ）thr26asn。结果 病例组患者617例中男性396例,女性221例;年龄37~64岁。健康对照组617人中男性396人,女性221人;年龄37~64岁。2组性别分布、平均年龄、舒张压和收缩压的差异均无统计学意义（均P>0.05）。2组控制体重、吸烟、饮酒、睡眠时间、体育锻炼、饮食健康情况比较,差异均有统计学意义（P<0.05或P<0.01）;FGB G（-455）A、ELAM ser128arg、ICAM1 gly214arg、TNFαG（-308）A、TNFβ thr26asn等位基因频率比较,差异均无统计学意义（均P>0.05）;FGB G（-455）A、ELAM ser128arg、ICAM1 gly214arg、TNFαG（-308）A基因型频率比较,差异均无统计学意义（均P >0.05）,而TNFβ thr26asn基因型频率比较,差异有统计学意义（P<0.05）。结论 中青年缺血性脑卒中具有遗传因素,与TNFβ thr26asn多态性可能存在一定关联,寻求遗传病因学证据及建立良好生活行为习惯,如控制体重、戒烟限酒、保证充足睡眠、坚持体育锻炼和健康饮食等,有利于中青年缺血性脑卒中的防治。     

厦门市1993～2000年儿童死因动态及生存水平分析

目的　了解厦门市 5岁以下儿童死因变化及生存水平 ,提高儿童的生命质量及医疗保健服务水平。方法　通过市、区、街道 (乡 )妇幼保健三级网及儿童生命监测系统收集资料 ,对 1993～ 2 0 0 0年厦门市 5岁以下儿童死亡监测情况统计分析。结果　 5岁以下儿童死亡率呈逐年下降趋势 ,1993年为 2 7 88‰ ,2 0 0 0年为 11 6 6‰ ,(X2 =80 0 0 ,P <0 0 1)。厦门市 1993～ 2 0 0 0年 5岁以下儿童主要死因为肺炎、出生窒息、早产、先天畸形、腹泻 ,肺炎和腹泻呈下降趋势 ,早产、出生窒息、先天畸形呈上升趋势 ,其中先天畸形上升较明显。儿童死前均得到相应的医疗保健服务 ,死前就医、死前明确诊断、死于医疗保健机构者均达 90 %以上。结论　厦门市 5岁以下儿童死亡率逐年下降 ,已达到《九十年代中国儿童发展规划纲要》的要求。提高医疗保健机构的诊治水平和服务水平是社会的需求 ,也是提高儿童生存水平的措施之一 ,全社会都应重视这项工作。     

Timing of Readmissions After Elective Total Hip and Knee Arthroplasty: Does a 30-Day All-Cause Rate Capture Surgically Relevant Readmissions?

BackgroundThe 30-day all-cause readmission rate is a widely used metric of hospital performance. However, there is lack of clarity as to whether 30 days is an appropriate time frame following surgical procedures. Our aim is to determine whether a 90-day time window is superior to a 30-day time window in capturing surgically relevant readmissions after total hip arthroplasty (THA) and total knee arthroplasty (TKA).MethodsWe analyzed readmissions following all primary THAs and TKAs recorded in the English National Health Service Hospital Episode Statistics database from 2008 to 2018. We compared temporal patterns of 30- and 90-day readmission rates for the following types of readmission: all-cause, surgical, return to theater, and those related to specific surgical complications.ResultsA total of 1.47 million procedures were recorded. After THA and TKA, over three-quarters of 90-day surgical readmissions took place within the first 30 days (78.5% and 75.7%, respectively). All-cause and surgical readmissions both peaked at day 4 and followed a similar temporal course thereafter. The ratio of surgical to medical readmissions was greater for THA than for TKA, with THA dislocation both being one of the most common surgical complications and clustering early after discharge, with 73.5% of 90-day dislocations occurring within the first 30 days.ConclusionThe 30-day all-cause readmission rate is a good reflection of surgically relevant readmissions that take place in the first 90 days after THA and TKA.     

童年期居住环境卫生对农村居民中老年期慢性病患病的影响研究

目的探讨童年期居住环境卫生对农村居民中老年期慢性病患病的影响, 并检验童年期健康状况在其中的中介效应。方法基于中国健康与养老追踪调查2018年最新调查和2014年生命历程调查共同访问的12 506名农村居民数据, 运用χ2检验、秩和检验、logistic回归分析模型、倾向评分加权法、负二项回归模型和KHB分析法进行分析。结果调整其他混杂因素后, 相比童年期居住环境卫生较好的农村居民, 童年居住环境卫生较差的中老年农村居民患哮喘风险提高23.7%(OR=1.237, 95%CI:1.060～1.445), 患肝脏疾病、肾脏疾病和消化系统疾病的风险增加16.4%(OR=1.164, 95%CI:1.006～1.347)、22.4%(OR=1.224, 95%CI:1.083～1.383)和19.6%(OR=1.196, 95%CI:1.103～1.296), 患血脂异常和心脏病的可能性上升了26.6%(OR=1.266, 95%CI:1.153～1.390)和13.6%(OR=1.136, 95%CI:1.031～1.253)。负二项回归模型分析结果显示, 童年居住环境卫生较差的中老年农村...     

Health dynamics shape life-cycle incomes

This paper empirically investigates the long-run effects of major health improvements on income growth in the United States. To isolate exogenous changes in health, the econometric model uses quasi-experimental variation in cardiovascular disease mortality across states over time. Based on data for the white population, the results show that there is a causal link between health and income per person, and they provide novel evidence that health dynamics shape life-cycle incomes. Life-cycle income profiles slope more strongly at the beginning and at the end of work life in 2000 than in 1960, indicating that age becomes a more prominent determinant of income dynamics over this period. The channels for this transformation include better health, higher educational attainment, and changing labor supply.     

1999-2018年天津市居民平均期望寿命变化分析

目的 分析近20年天津市居民期望寿命变化规律以及对期望寿命增量的影响因素。方法 应用简略寿命表、期望寿命差异的年龄和死因分解法对天津市户籍居民1999-2018年死因监测数据进行分析,计算不同年龄、不同疾病死亡率对期望寿命增量的贡献值和百分比。结果 20年间天津市户籍居民期望寿命增加了4.97岁,男性、女性期望寿命分别增加4.11岁和5.86岁,女性增幅高于男性。0岁组死亡率下降对期望寿命增加的贡献率为19.17%,≥55岁组居民死亡率下降对期望寿命的增加贡献较大,累计贡献率为67.38%。脑血管病、呼吸系统疾病、心脏病、围生期情况、先天畸形以及损伤和中毒死亡率下降对期望寿命提高的贡献较大,贡献率分别为27.27%、21.37%、15.76%、12.22%、6.44%和4.86%。恶性肿瘤、损伤和中毒、糖尿病、神经系统疾病等死亡率的增加对≥75岁人群寿命增长产生负向作用。天津市期望寿命增加具有阶段性特点,1999-2011年为76.72~81.46岁,具有上升趋势（t=9.11,P<0.001）,年度变化百分比（APC）为0.58%;2011-2018年为81.46~81.69岁,为平稳趋势（t=0.89,P=0.387）,APC为0.13%。结论 1999-2018年天津市居民期望寿命增长主要归因于婴儿、老年人、脑血管病、呼吸系统疾病、心脏病、围生期情况、先天畸形以及损伤和中毒死亡率的下降,而≥75岁人群恶性肿瘤、损伤和中毒、糖尿病、神经系统疾病等死亡率的增加对期望寿命增长产生了负向作用。应加强重点人群、重点疾病的综合防治,进一步提高人群期望寿命。     

上海市居民期望寿命与健康期望寿命的差异分析

目的 分析不同年龄、性别的上海市居民期望寿命和健康期望寿命的差异。方法 分析比较上海市和全球长寿国家/地区期望寿命的变化趋势;利用全球疾病负担研究建立的疾病和健康结局的失能权重,应用Sullivan法测算上海市居民健康期望寿命,并分析不同年龄、性别人群的健康寿命损失。结果 近40年,上海市期望寿命增长了10.86岁,2016年上海市居民期望寿命为83.18岁,其中男性80.83岁,女性85.61岁。健康期望寿命为69.46岁,其中男性为68.68岁,女性为70.23岁;与期望寿命的差距分别为13.72、12.15和15.38岁;分别占期望寿命的16.49%、15.02%和17.97%。与期望寿命相同,各年龄组女性的健康期望寿命均高于男性,平均差距为1.76岁,两者差距在20~24岁组最小为1.36岁,70~74岁组最大为2.24岁。健康期望寿命损失率随着年龄的上升而上升,<65岁女性高于男性,≥65岁则相反。结论 上海市期望寿命已达世界领先水平,但健康寿命损失较大,需要在降低死亡率的基础上进一步提高寿命质量,尤其是女性和≥65岁男性是重点关注人群。     

山东省居民高盐饮食对死亡和期望寿命的影响

目的分析山东省居民归因高盐饮食相关疾病死亡和寿命损失。方法利用2016年山东省与原卫生部联合减盐防控高血压项目终末期评估调查获得的24 h尿钠和血压值,结合2016年全省居民死因监测数据,按照比较风险评估理论,计算各类疾病归因分值(PAF)和因高盐饮食导致死亡,利用寿命表法计算归因期望寿命损失。结果2016年山东省因高盐饮食导致死亡32987人,占相关疾病死亡的11.74%,占全部死亡的4.95%。男性因高盐死亡比例(13.51%)高于女性(9.17%)。高盐饮食导致死亡的疾病主要是心脑血管疾病(90.82%),其次为胃癌(8.10%)和慢性肾病(1.08%)。城市居民PAF(13.87%)高于农村(10.87%)。高盐饮食导致山东省居民期望寿命减少0.58岁。高盐饮食所致不同疾病对期望寿命损失作用不同,缺血性心脏病位居首位,其次为脑出血和脑梗死。结论山东省居民归因高盐饮食死亡的比例较高,心脑血管疾病是高盐饮食导致死亡的重要原因。高盐饮食严重影响山东省居民健康,还需加强减盐干预工作。