At,with and beyond risk: expectations of living with the possibility of future dementia

Biomedical research aimed at the development of therapies for chronic and late‐onset conditions increasingly concentrates on the early treatment of symptom‐less disease. This broad trend is evidenced in prominent shifts in contemporary dementia research. Revised diagnostic criteria and new approaches to clinical trials propose a focus on earlier stages of disease and prompt concerns about the implications of communicating test results associated with the risk of developing dementia when no effective treatments are available. This article examines expectations of the implications of learning test results related to dementia risk, based on focus group research conducted in the UK and Spain. It points to the extended social and temporal aspects of the dementia risk experience. Three key dimensions of this risk experience are elaborated: living ‘at risk’, represented in efforts to reduce risk and plan for the future; ‘with risk’, through vigilance towards cognitive health and earlier or prolonged contact with healthcare services; and finally, ‘beyond risk’ through a cessation of the self in its current social, legal and financial form. A virtual abstract of this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA     

Reconstructing the life course: health during early old age in a follow-up study based on the Boyd Orr cohort

A method is described for investigating life course influences on health in early old age. The lives of some 300 individuals at present aged 65-75 y have been reconstructed from the archived records of a pre-WWII survey, in which they took part as children, and from lifegrid interviews with the same individuals 60 y later. Despite loss to study at several points those interviewed are shown to be representative of the British population socio-demographically, in comparison with the 1931 and 1991 decennial censuses, and physically, in comparison with the Health Survey for England. Bias is conservative because the most disadvantaged were disproportionately affected by loss to follow-up through death and because non-responders to interview were more disadvantaged as children than the interviewees. Representativeness and conservative bias, it is argued, justify the use of these data for investigating life course influences on health in early old age.     

心血管内科住院患者医院感染现况及危险因素研究

目的探讨职工医院心血管内科医院感染发生的特点及影响因素,以减少医院感染的发生。方法对2011年4月—2014年4月心血管内科住院的患者医院感染发生情况进行回顾性分析,利用SPSS17.0软件,采用logistic回归分析模型进行影响因素探讨。结果心血管内科384例患者中,发生医院感染28例,医院感染率为7.29%。感染部位以呼吸道为主,占64.29%。共分离33株病原菌,其中革兰阴性菌占63.63%,肺炎克雷伯菌和铜绿假单胞菌分别占27.26%和21.22%。多因素logistic回归分析显示,年龄、住院时间、合并基础疾病、抗酸药物的应用、联合应用抗菌药物、侵入性操作和心功能分级是心血管内科住院患者发生医院感染的独立影响因素(P0.05)。结论心血管内科住院患者医院感染的风险较高,应增强对相关影响因素的认识,采取有针对性的防控措施,以降低医院感染的发生。     

以腹膜延长阴道提高年轻宫颈癌患者术后生活质量的临床研究

目的:探讨年轻宫颈癌患者采用腹膜延长阴道的临床意义和术后放疗对性功能的影响;方法:选择2007年以来住院年龄<45岁资料完整、随访可靠的宫颈癌患者73例分为两组,研究组41例行宫颈癌根治术加一侧或双侧卵巢移位加以腹膜延长阴道术,术前、术后3、6、12个月测性激素;对照组32例行宫颈癌根治术,或加一侧或双侧卵巢移位。两组术后高危因素者均行辅助放疗。结果:研究组术后测量阴道长度较对照组长,差异有统计学意义(P<0.01);放疗后阴道较放疗前缩短,但仍较对照组长,差异有统计学意义(P<0.01);研究组术后性生活满意度优于对照组。研究组15例行放疗,放疗后测FSH、LH明显升高,与放疗前差异有统计学意义(P<0.01),提示放疗后卵巢衰竭明显;未行放疗者卵巢功能无明显变化。结论:年轻宫颈癌患者采用腹膜延长阴道明显提高术后性生活质量,但术后行放疗是影响性功能的不利因素。     

Assessment of quality of life in the elderly assisted at home through a Tele-Check service

This study evaluates the effects of a Tele-check/Tele-emergency service on the quality of life in the elderly. Through telephone interviews a questionnaire has been repeatedly administered to explore various psychological, somatic, and social aspects in a random sample of 574 subjects aged 65 years and over (mean = 76.8 years). The findings suggest that the elderly helped by the service (in its control functioning) make less demands on health facilities (GPs visits, number of days in hospital) as compared to controls. Implications are presented and discussed.     

Associations between Early-Life Food Deprivation and Risk of Frailty of Middle-Age and Elderly People: Evidence from the China Health and Retirement Longitudinal Study

Background: The association between childhood food deprivation (FD) and health in later life has been extensively studied; however, studies on the association between childhood food deprivation and frailty are scarce. This study assessed the associations between childhood FD and the risk of frailty at middle-age and old age. Methods: Three waves of the China Health and Retirement Longitudinal Study (CHARLS), including 11,615 individuals aged over 45 years, were used for this research. Frailty was operationalized according to the FRAIL scale as a sum of fatigue, resistance, ambulation, illness, and the loss of weight. Childhood FD experiences and levels were measured by self-reported FD and historical content. Logistic mixed-effects models and proportional odds ordered logistic regression models were used to analyse the association between childhood FD and frailty. Findings: Childhood FD increased the odds of frailty at old age (1.30, 95% CI: 1.26–1.36). Compared with subjects with mild FD, those with extreme FD experiences had increased risks of frailty (1.34, 95% CI: 1.26–1.43). Subjects exposed to hunger at different ages all had an increased risk of frailty, and subjects who had FD during ages 6–12 (1.15, 95% CI: 1.09–1.22) were more likely to have an increased risk of frailty than those who had experienced FD in younger ages. The interaction of experience of FD at ages 0–6 and the experience of FD at ages 6–12 is not statistically significant after adjusting all covariates. Conclusions: Our findings suggest that childhood FD exerts long-lasting effects on frailty among older adults in China. The prevention of childhood FD may delay or even avert the emergence of frailty in people of middle-age and old age.     

延长CT球管寿命的方法

CT球管是CT的核心部件，球管的寿命不仅与球管的质量、安装调试以及机器本身状况有密切的关系．而且操作者使用得当与否也直接影响球管的寿命。利用多年安装、调试、使用CT机的经验，总结了一些延长CT球管寿命的方法．从技术和使用等多方面进行了论述。     

Community perceptions on the significant extension of life: An exploratory study among urban adults in Brisbane,Australia

Some researchers in the field of ageing claim that significant extension of the human lifespan will be possible in the near future. While many of these researchers have assumed that the community will welcome this technology, there has been very little research on community attitudes to life extension. This paper presents the results of an in-depth qualitative study of community attitudes to life extension across age groups and religious boundaries. There were 57 individual interviews, and 8 focus groups (totalling 72 focus group participants) conducted with community members in Brisbane, Australia. Community attitudes to life extension were more varied and complex than have been assumed by some biogerontologists and bioethicists. While some participants would welcome the opportunity to extend their lives others would not even entertain the possibility. This paper details these differences of opinion and reveals contrasting positions that reflect individualism or social concern among community members. The findings also highlight the relationship between Christianity, in particular belief in an afterlife, and attitudes to life extension technology. Overall, the study raises questions about the relationship between interest in life extension, the medicalisation of ageing and the increasing acceptability of enhancement technologies that need to be addressed in more representative samples of the community.     

丽水市医疗养老的调研及现状分析

目的调查丽水市医疗养老的现状，探索出一个适合丽水的养老方式。 方法通过实地走访、问卷调查、数据统计等方式对丽水市莲都区、龙泉市、青田县等地区的养老结构有所了解。 结果本文结合丽水市目前医疗养老的实际情况进行调研和分析，对丽水市"医养产业"发展探索出一个新的、满足社会需求的养老模式。 结论丽水市应从政府层面作为切入点，联合社会人士以及老人子女共同建设医养结合模式的养老机构。     

医疗设备经济使用年限的确定方法

随着我国社会主义市场经济的迅速发展,医疗卫生事业突飞猛进,各种具有先进技术的医疗设备相继装备医院,医疗设备管理已成为医院管理的重要组成部分,科学地确定医疗设备的经济使用年限将促进管理水平的提高.本文就医疗设备使用年限的范畴、经济使用年限计算方法等进行了较详细的探讨,以供交流.     

心血管内科住院患者医院感染高危因素分析

目的探讨心血管内科住院患者医院感染的危险因素。方法采用回顾性病例对照研究分析心血管内科患者的临床资料,将发生医院感染的患者作为病例组,未发生医院感染的患者作为对照组,比较两组患者在可能引起医院感染的因素变量上的差异。结果 2 308例患者发生医院感染117例,感染率为5.07%。感染部位以呼吸道为主(71例次,占60.68%);共分离病原菌90株,革兰阴性菌65株(占72.22%),革兰阳性菌20株(占22.22%),真菌5株(占5.56%)。单因素检验7个变量是影响医院感染的危险因素,经多因素非条件logistic回归分析,影响心血管内科的医院感染独立危险因素为年龄、心功能分级、血浆清蛋白水平、侵入性操作。结论心血管内科患者医院感染率较高,与多种因素有关。应对高龄、住院时间长患者密切关注,及时纠正心力衰竭,积极治疗合并症,尽量减少侵入性操作,严格无菌操作规程。     

医科大学生生命价值观的研究:现状、问题及趋势

医科大学生生命价值现研究是近年来日益受到学术界关注的领域.我国的生命价值观研究时间不长,取得了一些有价值的成果,但是对医科大学生生命价值观的内涵、内容、现状、意义和方法等尚未形成一致的看法.文章尝试梳理医科大学生生命价值观的研究现状,提出个人观点,在就研究中存在的一些问题展开论述之后进一步指出医科大学生生命价值观研究的趋势所在.     

Age of Initiation, Smoking Patterns, and Risk in a Population of Working Adults

Background. Early age of initiation is a significant risk factor for long-term dependent smoking and may also relate to other unhealthy behaviors and increased likelihood of illness, independent of duration of smoking.Methods. The current study assessed age of initiation in relation to cigarette dependence, interest in quit ting, social environment pertaining to smoking, behavioral risk factors, and current health problems. Subjects were 2120 current daily smokers in 24 worksites in the Minneapolis/St. Paul, Minnesota, metropolitan area.Results. Findings were surprisingly consistent with early age of initiation predicting more dependent smoking, less interest and confidence in ability to quit, poorer diet, less use of seat belts, more illness and hospitalization, and greater likelihood of smoking among partner/spouse, friends, and co-workers.Conclusions. The overall strength of the findings was unexpected. Early initiation of regular smoking predicted a significant constellation of risk factors throughout adulthood. Interventions that significantly delay smoking onset, even in the absence of permanent prevention, could have important public health implications.     

Closing down the shop: Optimal health and wealth dynamics near the end of life

Near the end of life, health declines, mortality risk increases, and curative care is replaced by uninsured long‐term care, accelerating the fall in wealth. Whereas standard explanations emphasize inevitable aging processes, we propose a complementary closing down the shop justification where agents' decisions affect their health and the timing of death. Despite preferring to live, individuals optimally deplete their health and wealth towards levels associated with high death risk and gradual indifference between life and death. Reinstating exogenous aging processes reinforces the relevance of closing down. Using Health and Retirement Study–Consumption and Activities Mail Survey data for elders, a structural estimation of the closed‐form decisions identifies, tests, and confirms the relevance of closing down.     

中年知识分子生存质量影响因素分析

目的了解贵州省贵阳市中年知识分子生存质量现状及影响因素,为其提供有效的健康保健。方法采用分层整群抽样的方法,自某地不同行业中抽取40~60岁、中专或中级职称以上的在职人员1315名作为研究对象,用世界卫生组织生存质量量表WHOQOL-BREF和自编调查问卷按自填方式实施集体调查。结果中年知识分子生存质量状况不理想,14.9%较差,生存质量得分较差的领域是心理领域(54.2±12.5)分、最差的是环境领域(41.8±15.1)分;影响因素有学历、睡眠时间、体育锻炼情况、2周患病情况、是否患有慢性病及医疗付费方式等(P<0.05)。影响生存质量的因素由大到小依次为体育锻炼情况、2周是否患病、是否患有慢性病、医疗付费方式、学历(P<0.05)。结论中年知识分子的生存质量较差,主要是心理健康状况较差及生活环境相对不理想所致。影响生存质量的因素与社会心理、行为相关。     

京津沪老年人经济收入对健康状况的影响

探讨经济收入的不同对老年健康状况的影响。方法；以京、津，沪三直辖市老年人为研究对象，利用简略寿命表方法分别计算不同收入状况下的健康期望寿命。结果；无独立个人收入的ＡＬＥ低于有收入的ＡＬＥ，低收入的ＡＬＥ低于高收入的ＡＬＥ。结论；老年人有无独立收入及经济收入的高低对其健康状况有直接影响。     

The role of governmentality in the establishment,maintenance and demise of professional jurisdictions: the case of geriatric medicine

This paper examines the professionalising of geriatric medicine in the UK roughly between the 1940s and the 1970s and locates it in terms of the broader context of the relationship between the professions and the state. It looks at how this relationship shaped geriatric medicine’s professional jurisdiction, including the discourses of expertise on the one hand and the constituting of the ‘subjects’ of such expertise on the other. In contrast to other sociological approaches to the professions, which highlight the negative impact of state encroachment on professional territory, this paper contends that without the backing of the Ministry of Health the specialty may never have established itself in the face of prolonged opposition from rival specialists. However, such support was predicated on the specialty’s highlighting particular legitimating discourses and practices at the expense of others, and in framing this in terms of specific policy concerns around an ageing population. Whilst this imprinted the profession with the stamp of governmentality, it also contributed to the broader problematising of old age in the twentieth century. The paper concludes by considering the legacy of this context of professionalisation for the profession today.     

医学化学理论教学的延伸和拓展

医学研究工作已逐渐进入分子水平,促使化学与生物和医学的联系更加紧密.正是基于这样的原因,化学的教学改革就显得特别重要,也势在必行.化学教学应在重视基础同时,加强与其它基础学科和临床学科的联系.     

生活方式与血压关系的研究

目的 探讨生活方式与血压之间的关系。方法 采用流行病学现况研究的方法，对重庆市某厂5个车间所有45—55岁的男性进行调查。结果 该人群平均年龄51岁，平均收缩压(SBP)与舒张压(DBP)分别为120．21mmHg(15．99kPa)，79．89mmHg(10．63kPa)。高血压现患率为20．3％，高胆固醇血症现患率为16．7％，超重率为23．4％。单因素分析显示，体重指数(BMI)与SBP和DBP均呈正相关(r=0．33，r=0．41，P＜0．01)。超重的人(RMI＞25kg／m^2)其SBP、DBP、血清总胆固醇(TC)、TC／HDL值均较体重指数正常高。Logistic回归分析显示，超重是高血压患病的危险因素，0R值为4．92(2．43—9．95)。24h尿钠排出量与血压呈弱的相关(r＝0．23，r＝0．22，P＜0．05)，钠／钾均值为6．77，钠／钾高于建议值范围(比值＜3)的比例占98．55％。化程度高(受教育年数≥10年)有低的高血压现患(5．65％)，其血压水平、尿钠排出量、钠／钾均较中、低化程度的低。结论 超重、膳食高盐为重庆地区抽样人群高血压患病的危险因素，教育在中国人群血压控制中扮演着重要的角色。