基于2018中国家庭追踪调查数据分析65岁及以上居民自评健康状况影响因素

目的本研究基于2018中国家庭追踪调查(CFPS)数据分析≥65岁老年人口自评健康状况及影响因素,为提高我国老年人口生存质量提供参考依据。方法使用CFPS数据对我国≥65岁老年人自评健康情况进行分析,自评健康状况分为非常健康、很健康、比较健康、一般和不健康,利用多分类Logistic回归分析老年人自评健康状况影响因素。结果本研究最终纳入5 174名≥65岁老年人,认为自身较为健康的占51.74%,认为不健康的占31.29%。单因素分析结果显示,性别(χ~2=78.023,P<0.001)、学历(χ~2=154.423,P<0.001)、工作状态(χ~2=118.280,P<0.001)、患有慢性病(χ~2=417.055,P<0.001)和过去两周身体是否不适(χ~2=747.681,P<0.001)与自评健康状况有关联。多元Logistic回归分析结果显示,学历(OR=0.935,95%CI为0.888～0.983,P=0.009)、年龄(OR=0.932,95%CI为0.884～0.981,P=0.007)、工作状态(OR=1.758,95%CI为1.572～1.965,P<0.001)、身体状态(OR=0.286,95%CI为0.257～0.320,P<0.001)、患有慢性病(OR=0.453,95%CI为0.404～0.508,P<0.001)、饮酒(OR=1.456,95%CI为1.267～1.674,P<0.001)和体育锻炼(OR=1.564,95%CI为1.407～1.738,P<0.001)是老年人自评健康状况的影响因素。结论我国老年人口自评健康倾向较为积极,学历、年龄、工作状态、身体状态、患有慢性病、饮酒和锻炼身体是≥65岁老年人自评健康状况影响因素。     

我国老年人自评健康现状及影响因素分析

目的了解我国≥60岁老年人的自评健康状况,并探讨其影响因素,为提高老年健康水平提供参考。方法利用2013年中国慢性病及其危险因素监测收集的相关信息,将51 255名≥60岁的常住居民作为研究对象。老年人自评健康状况问题参考美国行为危险因素调查(BRFSS)。样本复杂加权后,计算自评健康状况的总体分布及健康受到疾病、伤害、心理和情绪问题影响的比例。采用SAS 9.4软件进行χ2检验、偏比例优势模型和logit模型分析。结果老年人自评健康状况为好、一般、差的比例分别为28.82%(95%CI:27.19%～30.45%)、55.34%(95%CI:54.00%～56.69%)和15.84%(95%CI:14.78%～16.90%)。偏比例优势模型结果显示,自评健康状况随着年龄增高、受教育程度降低、地区从东部到中部再到西部,自评健康状况逐渐变差(P0.05,P0.01)。农村、女性老年人自评健康状况更差(P0.01)。老年人过去30 d疾病率为33.78%(95%CI:31.03%～36.52%),伤害率为12.49%(95%CI:9.59%～15.39%),心理和情绪问题率为18.96%(95%CI:16.08%～21.85%)。logit模型结果显示,随着年龄的增加,疾病率增加,农村、西部地区、女性有更高的疾病率(OR值分别为1.10、1.79和1.28,P0.01)。西部、农村老年人伤害率更高(OR值分别为1.81、1.19,P0.01);西部、农村、女性老年人有更高的心理情绪问题率(OR值分别为1.70、1.15和1.24,P0.01)。结论中国老年人自评健康状况总体一般。老年人的身体及心理健康状况应该引起重视,尤其是西部地区及女性老年人,改善老年人健康状况的政策措施应更有针对性。     

我国60～65岁老年人自评健康与工作状态关系研究

目的了解60~65岁人群的工作状态及健康水平,为延迟退休政策提供依据。方法数据来源于2015年中国健康与养老追踪调查,单因素分析采用卡方检验,运用二分类Logistics回归分析老年人工作状况和自评健康的关系。结果 60~65岁老年人继续工作的人群占47.0%,自评健康好的比例为56.5%。在控制性别、学历、参加社交活动的频次、睡眠时间、生活自理能力(Activities for Daily Living,ADL)、患慢性病数量和退休时身份后,自评健康好和一般的老年人完全退休的可能性分别是自评健康差的老年人的0.330倍和0.372倍(OR=0.330,P0.001,OR=0.372,P0.01)。结论自评健康越好的老年人越可能会继续工作,应加强60~65岁年龄段老年人健康管理,提高该人群的健康水平,为延迟退休政策提供健康支持。     

公共健康教育对流动老人健康的影响——基于农村老年流动人口视角

目的 基于农村流动人口的视角分析公共健康教育对我国农村流动老人健康的影响。方法 基于全国流动人口动态监测调查2015年调查数据，运用Probit模型以及倾向得分匹配方法分析公共健康教育对农村流动老人健康的影响。结果 接受公共健康教育使农村老年流动人口的自评健康状况向好的概率增加2.4%（0.5%～4.3%,P＜0.05）。纠正变量间的内生性后，公共健康教育使农村流动老人自评健康向好的概率增加2.5%～2.9%（P＜0.01）。异质性分析发现公共健康教育对高龄、高文化水平、东部地区的农村流动老人健康的影响更大。结论 公共健康教育对农村老年流动人口的健康状况有显著的正面影响。应充分考虑老年流动人口的特征，关注不同类别、不同文化水平农村流动老人的偏好，提供契合流动老年人的合理教育方式。     

劳动参与对退休老年群体健康的影响研究

目的:了解退休老年群体劳动参与行为对其健康状况的影响.方法:利用2011年、2013年、2015年中国健康与养老追踪调查(CHARLS)全国数据,以报告已办理退休手续的1757名60岁及以上老年人作为研究对象,使用倾向得分匹配法研究退休后劳动参与行为对健康的影响.结果:劳动参与对退休老年群体自评健康、日常生活能力及慢性...     

老年人日常生活能力现状及影响因素分析

目的了解老年人日常生活能力现状及影响因素,为提高老年人日常生活能力、促进健康老龄化提供依据。方法采用PPS(概率比例规模抽样)的方法抽取浙江、甘肃两省60岁及以上的老年人1 157名进行躯体性日常生活能力和工具性日常生活能力调查。结果 1 157名老年人中,躯体性日常生活能力(PADL)的受损率为18.5%,工具性日常生活能力(IADL)的受损率为48.4%;多因素分析结果显示:性别、年龄、省份、自评健康状况、有无慢性病是PADL的影响因素;性别、年龄、教育程度、婚姻、消费性支出、省份、自评健康状况、城乡是IADL的影响因素。结论女性、高龄、自评健康状况差、患有慢性病是PADL的危险因素;女性、高龄、教育程度低、无配偶、经济水平低、自评健康差是IADL的危险因素,应针对危险因素采取有效措施,提高老年人的健康水平和生活质量。     

卫生服务供给与利用对老年人口健康自评的影响研究

目的探讨卫生服务供给与利用对老年人口健康自评的影响,为提高老年人健康水平政策的制定提供参考依据。方法利用2014年CLHLS数据,共有3 563名老年人纳入研究。结果分析采用有序logistic回归模型。结果 3 563名老年人中健康自评为好的占41.6%,一般的占40.5%,差的占17.9%。年龄、生病能否及时就医、是否定期体检、是否具有城镇居民医疗保险对老年人口健康自评影响显著(P0.05)。结论应重点关注高龄老人的健康状况;适当加大财政投入,减轻低收入老年人的看病负担;加快统一城乡居民医疗保险;倡导老年人养成良好的健康行为习惯。     

社会参与和社会信任对老年群体健康状况的影响

目的 探讨社会参与及社会信任对老年人健康状况的影响.方法 用PPS法随机抽样选取3150例老年人为研究对象,采用logit多元回归分析法分析社会参与和社会信任对老年群体健康状况的影响.结果 休闲活动参与度、性别等自变量和控制变量会对老年群体的躯体功能健康产生显著影响(P＜0.001);休闲活动参与度、独居和文化程度等自...     

基于Fairlie分解法城乡老年人自评健康状况比较

目的了解中国城乡老年人的自评健康状况及城乡差异,为缩小城乡老年人健康差异、提高老年人健康公平性提供参考依据。方法收集2014年中国家庭动态跟踪调查(CFPS)中全国25个省/市/自治区4 058名≥65岁老年人自评健康相关数据,应用Stata 12.0软件进行Fairlie分解,分析城乡老年人健康现状及其差异。结果 4 058名≥65岁老年人中,自评健康者1 977人,自评健康率为48.72%;城镇老年人自评健康率为51.40%,高于乡村老年人的46.37%,城乡老年人自评健康状况差异有统计学意义(χ~2=10.21,P=0.001)。多因素非条件logistic回归分析结果显示,饮酒和锻炼的城镇老年人自评健康状况较好,女性城镇老年人自评健康状况较差;中学、吸烟、饮酒和锻炼的乡村老年人自评健康状况较好。Fairlie分解结果显示,城乡老年人健康状况差异中的51.29%是可观测因素造成的,另外48.71%是城乡地域属性本身造成的;各因素分解结果显示,生活方式对城乡老年人自评健康状况差异的影响有统计学意义(β=0.016 4,P=0.007),贡献率达32.60%。结论城镇老年人自评健康状况优于老年人,生活方式是造成城乡老年人自评健康状况差异的主要因素。     

健康素养在社会经济地位与自评健康之间的中介效应调查研究

目的解析居民健康素养在社会经济地位与自评健康之间的中介效应,为更好地理解健康素养的科学价值提供依据。方法采用多阶段分层抽样方法,随机选取13 920名15～69岁城乡居民进行面对面调查,应用Hayes(2018)宏分析居民健康素养在社会经济地位与健康之间的中介效应。结果在控制了年龄、性别、婚姻和民族等因素后,文化程度、职业和经济水平对自评健康的总效应值分别为0.074(P0.01)、0.015(P0.01)和0.074(P0.01),健康素养在文化程度、职业和经济收入与自评健康之间具有部分中介效应,相对效应值分别为12.16%、6.67%和2.70%。结论健康素养在社会经济地位与自评健康之间具有中介效应,提升健康素养水平,有利于促进居民健康。     

Performance, proficiency, and value of the dietetics professional: an update

The major focus of the plan is the possible professional development activities provided by the Association and used by members. Ultimately, the Plan offers the Association and members concise and doable tactics for addressing the number one member concern of compensation and benefits.All organizational units of ADA will examine opportunities for developing tools, gathering data, and exploring tactics to build on current programs that will close the gap between performance, proficiency, and value for the profession. Likewise, members are encouraged to use ADA resources, such as the PPV Plan’s tactics to build their professional development plans. Members should also consider investigating outside services or employer resources that compliment the opportunities that ADA offers.The following Professional Development Sessions are planned for the 2003 Food and Nutrition Conference & Expo in San Antonio (October 25–28).Saturday, October 25, 20035:00–7:00 pm—Live Up to Your Dreams: Opening Session Ross Keynote Address, Dot Richardson, MDSunday, October 26, 20038:30–10:00 am—Customer Satisfaction: Creating Demands for our Services8:30–10:00 am—ADA Forum for Students and New Professionals10:30–12:00 pm—Managing your Professional Development Portfolio1:30–3:00 pm—Adding Value Through Differences: Anyone Can Become a Leader3:30–5:00 pm—The Enterprising Dietitian: Building a Diabetes Business with RN Partners3:30–5:00 pm—Business and Communications: Career Opportunities for DietitiansMonday, October 27, 20038:00–9:30 am—Positive Attitude: The Key to Success in Nutrition and Dietetics12:30–1;30 pm—ADA’s Reality Show: Real Stories, Real Members, Real Prizes2:00–3:30 pm—Communications Seminar: How to Manage your Mouth4:00–5:30 pm—You can Have it all: Leadership and Life BalanceTuesday, October 28, 20038:00–9:30 am—Gain-Gain: A New Look at Salary Negotiation10:00 am–11:00 am—Negotiation Skills for Young Professionals10:00–11:00 am—Member Forum: How to Get Involved, ADA Needs You     

BOOK REVIEWS

Book reviewed in this article: H. Goldstein: Social Learning and Change. A Cognitive Approach to Human Services (Tavistock, London 1981/1985 [paper] and H. Goldstein, H. Hilbert and J. Hilbert (eds.): Creative Change. A Cognitive-Humanistic Approach to Social Work Practice E.M. Goldberg, J. Gibbons, L. Sinclair: Problems, Tasks and Outcomes — The Evaluation of Task-Centred Casework in Three Settings Alan Walker: Social Planning. A strategy for Socialist Welfare Ann Brechin and Penny Liddiard: Look at it this way: New perspectives in rehabilitation S. Ayer and A. Alaszowski: Community Care and the Mentally Handicapped Robin Means and Randall Smith: The Development of Welfare Services for Elderly People H.S. Sudak, A.B. Ford and N.B. Rushforth (eds.) Suicide in the Young Boston Women's Health Book Collective: The New Our Bodies Ourselves Jeannette Mitchell: What is to be done about Illness and Health? Erica Bates and Helen Lapsley: The Health Machine: The Impact of Medical Technology G. Henderson and M. Cohen: The Chinese Hospital — A Socialist Work Unit Mark Harwell: Nuclear Winter: The Human and Environmental Consequences of Nuclear War Owen Green, Ian Percival and Irene Ridge: Nuclear Winter: the Evidence and Risks Steven Rose, Leon J. Kamin and R.C. Lewontin: Not in our Genes: Biology, Ideology and Human Nature P.F. Ricci, L.A. Sagan and C.G. Whipple (eds): Technological Risk Assessment J. Cavanagh, F. Clairmonte: Alcoholic beverages: Dimensions of corporate power. Alex Paton (ed.): Handbook on Alcoholism for Health Professionals Marcus Grant: Same Again: A Guide to Safer Drinking B. MacMahon and T. Sugimura (eds.): Coffee and Health. P. Ebbesen, M. Melbye and R.J. Biggar (eds.): AIDS. A Basic Guide for Clinicians Bert Spilker: Guide to Clinical Studies and Developing Protocols P. Leudtke and R. Leudtke: Computers for Medical Offices Tyckoson, David: AIDS (Acquired Immune Deficiency Syndrome).     

Hepatitis C virus infection in injection drug users in Bavaria: risk factors for seropositivity

Background: Hepatitis C Virus (HCV) infection is the most common disease among intravenous drug users (IDUs). Patients and method: All patients admitted to the detoxification unit 1991–1997 and meeting ICD-10 diagnosis of opioid dependency were tested for anti-HCV serology. Results: Thousand and forty nine patients were included in the study. About 61.3% of the IDUs were anti-HCV positive. Increasing age (PR: 1.46; 95% CI: 1.34–1.60), living with a significant other drug user (PR: 1.17; 95% CI: 1.05–1.31), history of therapy (PR: 1.62; 95% CI: 1.50–1.74), history of imprisonment (PR: 1.48; 95% CI: 1.36–1.61), history of emergency treatment (PR: 1.23; 95% CI: 1.12–1.35), additional daily consumption of benzodiazepines (PR: 1.10; 95% CI: 1.00–2.21) or alcohol (PR: 1.26; 95% CI: 1.14–1.38), frequency of injecting heroin (daily: PR: 0.86; 95% CI: 0.78–0.96; previously: PR: 1.14; 95% CI: 1.03–1.26) and type of opioid dependency (methadone: PR: 1.26; 95% CI: 1.13–1.41) were significant factors, considered as individual factors, for positive anti-HCV serology. Using multiple logistic regression we found that older age (OR: 3.54, 95% CI: 1.30–9.67), longer duration of opioid use (OR: 5.74; 95% CI: 1.82–18.13), living with a significant other drug user (OR: 1.47; 95% CI: 1.01–2.16), history of therapy (OR: 4.87; 95% CI: 1.67–14.20), history of imprisonment (OR: 1.92; 95% CI: 1.12–3.28), history of emergency treatment (OR: 1.45; 95% CI: 1.06–1.99) and additional daily consumption of alcohol (OR: 1.49; 95% CI: 1.04–2.13) remained independently associated with positive anti-HCV serology. Conclusions: These data support the need for early prevention strategies, namely, education of teachers in schools and further training of counsellors informing IDUs of what they can do to minimise the risk of becoming infected or of transmitting infectious agents to others.     

Artificial oocyte activation: physiological,pathophysiological and ethical aspects

Infertile couples with low oocyte yield in combination with abnormal semen parameters may experience intra-cytoplasmic sperm injection (ICSI) failure. An established factor associated with ICSI failure is oocyte activation deficiency (AOD). The latter originates from seminal contributors, such as phospholipase C-zeta (PLCζ) that is not adequate to produce calcium (Ca²⁺) oscillations for oocyte activation. Apart from this natural activator, other stimulants, such as A23187, ionomycin, strontium chloride or even electric pulses, have been used in embryological laboratories to overcome AOD and ICSI failure. The aim of the present narrative review is to discuss the role of Ca⁺² oscillations in oocyte activation and summarize the evidence concerning the use of oocyte activators as agents for artificial oocyte activation (AOA). Studies in humans and animals have emerged many physiological, pathophysiological and ethical aspects of AOA. In conclusion, in mammalian eggs, the cytosolic Ca⁺² oscillations derive from a periodic release of Ca⁺² from intracellular pools. PLCζ, as well as artificial stimulants, have been used to produce Ca⁺² oscillations for AOA. As the latter may increase the risk of epigenetic induced malformations, further studies are required to clarify whether AOA constitutes an effective and safe method to overcome ICSI failure.

Abbreviations: AOA: artificial oocyte activation; AOD: oocyte activation deficiency; Ca⁺²: Calcium; CAMKII: Ca⁺²/calmodulin-dependent protein kinase II; CICR: calcium-induced calcium-release; DAG: diacylglycerol; GM-CSF: granulocyte-macrophage colony-stimulating factor; ICSI: intra-cytoplasmic sperm injection; InsP₃R: inositol-trisphosphate receptor; IP₃: inositol 1,4,5-trisphosphate; IVF: in vitro fertilization; MAP: mitogen-activated protein; MII: metaphase II; NADP: nicotinic acid adenine dinucleotide phosphate; NO: nitric oxide; PAWP: post-acrosomal WW-binding domain protein; PIP₂: phosphatidylinositol 4,5-bisphosphate; PLC: phospholipase C; PLCζ: phospholipase C-zeta; SOAFs: spermatozoon-released oocyte-activating factors; Sr⁺²: strontium; TFF: total fertilization failure     

BOOK REVIEWS

Book reviewed in this article: Paul J Feldstein: The Politics of Health Legislation: An Economic Perspective John L. Palmer, Timothy Smeeding and Barbara Boyle Torrey (eds.): The Vulnerable J.R.G. Butler and D.P. Doessel (eds.): Health Economics: Australian Readings Research Unit in Health and Behavioural Change: Changing the Public Health Richard Winett, Abby King, and David Altman: Health Psychology & Public Health: An Integrative Approach Milton Lewis: Managing Madness - Psychiatry and Society in Australia 1788–1980 Robert H. Blank: Life, Death, and Public Policy Diane Wiesner: Alternative Medicine. A Guide for Patients and Health Professionals in Australia. Stuart F. Spicker, Ilai Alon, Andre de Vries and H. Tristram Engelhardt, Jr. (eds.): The Use of Human Beings in Research John M. Freeman & Kevin McDonnell: Tough Decisions: A Casebook in Medical Ethics Neil Thomson and Patricia Merrifield: Aboriginal Health: an annotated bibliography. Nick Heather and Ian Robertson: Problem Drinking: The New Approach Tim Stockwell and Sue Clement: Helping the Problem Drinker: New Initiatives in Community Care Elizabeth Prior Jonson: AIDS: Myths, Facts and Ethics Confronting AIDS: Update 1988 by the Institute of Medicine and the National Academy of Science. McCunney RJ (ed): Handbook of Occupational Medicine D. Christie: A Guide to Occupational Epidemiology. J.A. Baldwin et al. (eds): Textbook of Medical Record Linkage. G.W. Trinca, I.R. Johnston, B.J. Campbell, F.A. Haight, P.R. Knight, G.M. Mackay, A.J. McLean and E. Petrucelli. Reducing Traffic Injury - A global Challenge.     

Cleavage-stage embryo micromanipulation in the clinical setting

Embryo micromanipulation was developed after introduction of microinjection to overcome infertility. Embryo micromanipulation may be performed at any embryo stage from pronuclear to blastocyst. The technique started out as basic and turned out to be increasingly more complex. Embryo micromanipulation at the cleavage-stage includes a wide range of techniques, from opening the zona pellucida in order to improve the chance of implantation, to removing detrimental components from the embryo to enhance embryo development or blastomeres for preimplantation genetic diagnosis and embryo splitting. Evaluating the impact(s) of different micromanipulation techniques on epigenetics of the embryo and considering quality control during these techniques are important issues in this regard. This review aims to discuss the micromanipulation of cleavage-stage embryos in clinical assisted reproductive technology (ART).

Abbreviations: ART: assisted reproductive technology; ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilization; PGD: preimplantation genetic diagnosis; PZD: partial zona dissection; ZP: zona pellucida; SUZI: subzonal insemination; PVS: perivitelline space; AH: assisted hatching; LAH: laserassisted hatching; ZT: zona thinning; UV: ultraviolet; IR: infrared; PCR: polymerase chain reaction; FISH: fluorescent in situ hybridization; NGS: next generation sequencing; QC: quality control; QA: quality assurance     

BOOK REVIEWS

Book reviewed in this article: Helmut Althoff: Sudden Infant Death Syndrome (SIDS) Paul Ahmed (ed.): Living and Dying with Cancer F.C. Rose and M. Gawel: Migraine: The Facts R.B. Scott: Cancer: The Facts D. Barlow: Sexually Transmitted Diseases: The Facts D.W. Goodwin: Alcoholism: The Facts The Royal College of Psychiatrists: Alcohol and Alcoholism L.R. Walton, J.E. Walton, J.A. Scharffenberg: How you can five six extra years S. Areti: Understanding and helping the schizophrenic Neville Drury: The Healing Power — A Handbook of Alternative Medicine and Natural Health in Australia and New Zealand. Andrew Stanway: Alternative Medicine — A Guide to Natural Therapy. N.D. Darby, S. Glaser, I.F. Wilkinson: Health Care and Lifestyle — a Study of Self-Medication in Australia L. Eisenberg, and A. Kleinman (eds.): The Relevance of Social Science for Medicine A.E. Miller and E.G. Miller: Options for Health and Health Care Harold S. Luft: Health Maintenance Organizations K. Stanley, J. Stjernsward, M. Isley: The Conduct of a Cooperative Clinical Trial. J.R.J. Richardson and J.S. Deeble: Statistics of Private Medical Services in Australia, 1976. Avedis Donabedian: The Definition of Quality and Approaches to its Asessment Ann Cartwright and Robert Anderson: General Practice Revisited: A Second Study of Patients and their Doctors. L.E. Burton, H.H. Smith, A.W. Nichols: Public Health and Community Medicine. Torben Bendix and H.J. Wright: The Anxious Patient. Alwyn Smith (ed.): Recent Advances in Community Medicine 2 B.B. Taylor, J.M. Neale and B.C. Allan: Accommodation Change in Old Age C.J. Cooper and J. Marshall (eds.): White Collar and Professional Stress Judi Marshall and Cary L. Cooper (eds): Coping with Stress at Work Robin McKinley: The Care of Children in New Zealand Hospitals Frank Ainsworth and Leon C. Fulcher (eds): Group Care for Children: Concept and Issues. M.L. Wahlqvist (ed.): Food and Nutrition in Australia The Committee for the compilation of materials on damage caused by the atomic bombs in Hiroshima and Nagasaki: Hiroshima and Nagasaki — the Physical, Medical and Social Effects of the Atomic Bombings Gio Wiederhold: Databases for Health Care in D.A.B. Lindberg and P.L. Reichertz (eds.): Lecture Notes in Medical Informatics. A.L. Caplan et. al. (eds.): Concepts of Health and Disease