农村卫生适宜技术推广应用的影响因素及对策探讨

在浙江省农村卫生适宜技术的基层推广研究工作基础上，从决策管理、技术项目、推广主体和受体等多个角度，对现阶段影响农村卫生适宜技术推广应用的因素进行初步分析，并提出若干对策建议，为进一步开展农村卫生适宜技术基层推广应用提供决策参考。     

Professional mental health support seeking in Women of Refugee Background resettled in Australia: An exploratory study of facilitators and barriers

The present study is the first to investigate factors influencing professional mental health support seeking in Women of Refugee Background (WoRB) in Australia. WoRB are a vulnerable population with a range of complex mental health needs. Despite this, research has indicated that WoRB are an underrepresented population in the utilisation of mental health support services. This is a particular concern in Australia, due to an increasing number of WoRB being resettled. A multivariate logistical regression was conducted on a sample of 450 WoRB resettled in Australia from the Building a New Life in Australia (BNLA) data set to investigate factors associated with seeking professional mental health support. Several factors were identified as being significantly associated with professional mental health support seeking in WoRB resettled in Australia, including age, resettlement location, marital status, prearrival trauma involving violence against women, language barriers and health-related variables, including mental distress and long-term disability. The current study provides a unique insight into professional mental health support seeking from a gendered perspective in WoRB resettled in Australia. Insights into factors that influence seeking professional mental health support in this highly vulnerable population must inform mental health practice, service delivery and policies.     

北京市城区老年人生活质量及相关影响因素调查

目的了解老人的生活质量现况及其影响因素,为进一步提高老年人生活质量,实现健康老龄化提供科学依据。方法采用多阶段随机整群抽样的方法对来自北京市海淀区的1 850名老年人进行调查,利用生活质量评定简表(SF-36)和社会支持评定量表来测量社区老年人的生活质量以及社会支持状况。结果有效调查人数为1 809名,年龄在61～91岁之间,平均年龄为70.7岁。广义线性回归分析结果表明增龄、罹患疾病和移居经历均可导致老年人的生活质量下降;而与配偶同住、提高文化水平、积极参与社会活动以及获得社会支持则有助于从不同方面提高老年人的生活质量。结论老人的生活质量受诸多因素的影响,应该从社会和家庭多方面努力,提高老年人的心理和生理健康水平。     

An exploratory study of the health problems, stigmatization, life satisfaction, and literacy skills of urban, street-level sex workers

An exploratory study of 26 female urban, street-level sex workers was conducted to gather information about their health problems, feelings of stigmatizations, satisfaction with life, and literacy skills. Each woman completed the health questionnaire, Stigmatization Scale, Satisfaction with Life Scale, and the Rapid Estimate of Adult Literacy in Medicine. Twenty-one women had acute or chronic health problems; only eleven sought health care. Literacy scores revealed 7th to 8th grade reading levels. Feelings of stigmatization varied from low to high and all the women were found to be dissatisfied with their lives. Further research needs to address how these factors affect their use of health care and outreach services.     

Physicians' perspective on quality of life: An exploratory study of oncologists

There is an implicit assumption that physicians incorporate quality of life (QOL) information in clinical decision-making. However, very limited data exists on how physicians view QOL information and how they actually use it. To explore this issue, an in-depth study was conducted using a semistructured interview guide, with 60 oncologists in Canada and the USA. While the majority of respondents perceived QOL as important they reported a tendency to use it informally and not in all situations. Key findings include the belief expressed by 88% of respondents that the term QOL could be defined, although they differed in their definitions. Although 85% stated that QOL can be formally measured, only a third perceived that the current instruments provide valid and reliable data. Respondents noted a number of significant benefits and drawbacks of using QOL data in their clinical practice that had not been previously noted in the literature. For example, its use as an endpoint in clinical trials was generally perceived to enhance both physician and patient participation. A drawback noted was that including QOL might adversely affect the decision-making process. These findings have been used to develop a self-administered questionnaire (MD-QOL) which will test the generalizability of these findings.     

Individual,social, and physical environmental factors related to changes in walking and cycling for transport among older adults: A longitudinal study

To date, no longitudinal studies examined the change in walking and cycling for transport as distinct outcomes over time and investigated the predictors of those changes. Therefore, this present study examined the change in odds of engagement in walking and cycling for transport as distinct outcomes among Belgian older adults over a three-year follow-up period, and examined factors (i.e. socio-demographics, psychosocial, perceived social and physical environmental characteristics) related to these changes in engaging in walking and cycling for transport. Against our expectations, we found significantly higher odds of engaging in cycling for transport among older adults at follow-up compared to baseline and no significant differences in the odds of engaging in walking for transport. Interventions should assist older adults to increase their self-efficacy towards PA, their perceived benefits of PA, and their perception of land use mix diversity in their neighborhood in order to increase the engagement in walking/cycling for transport over time, or help to decrease their perceived barriers towards PA or their perception to have a lot of physical barriers to walk/cycle in their neighborhood. Future longitudinal studies with larger samples are warranted investigating interaction effects between different predictors at various levels to find out which factors can be further integrated into active transport interventions in older adults.     

Social capital and health in Australia: An overview from the household,income and labour dynamics in Australia survey

Social capital is associated with better health, but components of social capital and their associations with different types of health are rarely explored together. The aim of this study was to use nationally representative data to develop population norms of community participation and explore the relationships between structural and cognitive components of social capital with three forms of health – general health, mental health and physical functioning. Data were taken from Wave 6 (2006) of the Household, Income and Labour Dynamics in Australia Survey. Using individual-level data, the structural component of social capital (community participation) was measured using a twelve-item short-form of the Australian Community Participation Questionnaire, and the cognitive component (social cohesion) by sense of belonging, tangible support, trust and reciprocity. Three subscales of the SF-36 provided measures of health. Multiple hierarchical regression modelling was used to investigate multivariate relationships among these factors. Higher levels of participation were related to higher levels of social cohesion and to all three forms of (better) health, particularly strongly to mental health. These findings could not be accounted for by sex, age, Indigenous status, education, responsibility for dependents, paid work, living alone or poverty. Controlling for these and physical health, structural and cognitive components of social capital were each related to mental health, with support for a possible mediated relationship between the structural component and mental health. Social capital was related to three forms of health, especially to mental health. Notable gender differences in this relationship were evident, with women reporting greater community participation and social cohesion than men, yet worse mental health. Understanding the mechanisms underlying this apparent anomaly needs further exploration. Because community participation is amenable to intervention, subject to causal testing, our findings may assist in the development of programs which are effective in promoting social cohesion and, thereby, mental health.     

Healthy Cities Australia: the evaluation of the pilot project in Noarlunga, South Australia

This paper reports on the evaluation of the Healthy Cities (Noarlunga)Project which was one of the three original pilot cities inthe Australian Healthy Cities Project. The evaluation nethodologyused is outlined the project's organization and activities,and the data (from a variety of sources) used to assess itsachievements are discussed. These data were collected from arange of local informants including comnuinity members and froman analysis of the local print media. The implications of theevaluation findings for the development of the Healthy Citiesmovement are discussed.     

Unemployment, job insecurity and life satisfaction: results of a study with young adults in the new German states

Zusammenfassung. Fragestellung: Ausgehend von den zahlreichen Forschungen zu psychosozialen Aspekten des Erlebens von Arbeitslosigkeit untersucht die Studie die Folgen von tats?chlicher Arbeitslosigkeit auf die Lebenszufriedenheit und die Auswirkungen von Bedrohung durch Arbeitslosigkeit und wahrgenommener Sicherheit des Arbeitsplatzes auf die Lebenszufriedenheit. Methoden: Im Rahmen der 17. Welle der S?chsischen L?ngsschnittstudie wurden 2003 N = 419 Personen (193 M?nner, 226 Frauen, Mittleres Alter 30.05 Jahre) mit dem Fragebogen zur Lebenszufriedenheit (FLZ M) untersucht. Der Bogen erlaubt die ?konomische Erfassung von acht spezifischen Bereichen der Lebenszufriedenheit (Freunde, Freizeit, Gesundheit, Einkommen, Beruf, Wohnen, Familie, Partnerschaft). Ergebnisse: Zwei Drittel der Studienteilnehmer hatten bereits Erfahrungen mit Arbeitslosigkeit. Personen, die mehrfach arbeitslos waren, waren signifikant unzufriedener mit ihrem Einkommen, ihrer Wohnsituation, ihrem Beruf und ihrer Gesundheit. Jedoch hatten auch die Sicherheit des derzeitigen Arbeits- oder Ausbildungsplatzes und die subjektiv erlebte Bedrohung durch Arbeitslosigkeit bei derzeit Nichtarbeitslosen deutlich negative Auswirkungen auf deren Lebenszufriedenheit. Dies zeigte sich auch in Bereichen, die nicht direkt mit Erwerbsarbeit in Zusammenhang stehen, wie Freunde/Bekannte oder Familienleben. Schlussfolgerung: Die Studie unterstreicht bekannte Befunde zum Zusammenhang von Arbeitslosigkeit und (negativer) Lebenszufriedenheit. Nachgewiesen wird, dass auch bereits der antizipierte Verlust des Arbeitsplatzes zu einer eindeutig schlechteren subjektiven Lebenszufriedenheit in vielen Bereichen führt.

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Summary. Unemployment, job insecurity and life satisfaction: results of a study with young adults in the new German states Objectives: Based on research about the psychosocial aspects of experiencing unemployment, the present study analyses the effects of actual unemployment and the impact of being at risk of becoming unemployed and the influence of perceived job insecurity on life satisfaction. Methods: In the 17^th wave of the Saxon Longitudinal Study (S?chsische L?ngsschnittstudie) in 2003, 419 people (193 male, 226 female, mean age 30.05 years) were examined with a life satisfaction questionnaire. This questionnaire addresses eight areas of life satisfaction: friends, leisure time, health, income, job, housing, family, partnership. Results: Two-thirds of the participants have had experiences with unemployment so far. People who had been unemployed several times were significantly more dissatisfied with their income, housing, profession and health. Still, considering people employed at the time of survey, the subjective job insecurity and the perceived risk of becoming unemployed had noticeably negative effects on life satisfaction. This could be also shown for areas which are not directly connected to occupation, such as friends and family life. Conclusions: The study emphasizes the known results regarding the connection between unemployment and (poor) life satisfaction. Evidence was provided that even the anticipated loss of the workplace causes a decrease in life satisfaction, affecting many areas of subjective evaluation.

Wir danken der Otto-Brenner-Stiftung (http://www.otto-brenner-stiftung.de) für die freundliche Unterstützung der S?chsischen L?ngsschnittstudie.     

Conceptual equivalence and health-related quality of life: an exploratory study in Japanese and Dutch cancer patients

Research into the equivalence of Western and Japanese conceptualizations of health-related quality of life (HR-QOL) is scarce. We used the Western (European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30) and the Japanese (HRQoL-20) questionnaire in order to analyze the conceptual similarity of HR-QOL factors, and the associations between specific symptom items with overall HR-QOL in Japanese (n = 265) and Dutch (n = 174) patients with various types of cancer. Both populations completed both instruments. In both patient groups, the overall health scale of the EORTC-QLQ-C30 correlated highly (r = 0.59; p < 0.001) with the HRQOL-20 composite average score, indicating substantial conceptual comparability. Relationships between all EORTC-QLQ-C30 symptom items with HR-QOL were examined by ranking their correlations with the two overall measures of HR-QOL. Comparable patterns in the Japanese and Dutch samples were observed. The results suggest a considerable conceptual equivalence of HR-QOL in Japanese and Dutch cancer patients, and indicate a satisfactory structural and cross-cultural equivalence for the EORTC-QLQ-C30 with regard to items measuring functioning and specific symptoms. Longitudinal studies are needed to examine the impact of specific symptoms on general quality of life.     

老年人承担照料责任对生活满意度的影响：基于CLASS的多维考察

本研究依托2018年中国老年社会追踪调查(China Longitudinal Aging Social Survey, CLASS)数据,在基准回归模型估计基础上,运用倾向值加权法,对多维照料类型(照料孙辈和照料父母)与照料强度(单一照料或双重照料)下的老年人生活满意度进行分析,并基于“自主性”的角度和“进化论”的框架为此作出理论解释。结果显示,为孙辈和父母提供照料的老年人接近三成,照料工作总体上表现出显著的生活满意度增进效应;其中,超过八成的人照料孙辈,这方面照料工作的正向作用明显更加突出,而照料父母则基本不显示积极的影响;同时照料孙辈与父母也未能实现老年生活满意度的改善。     

Iron status among Australian adults: findings of a population based study in Queensland, Australia

OBJECTIVES: To describe the concentrations of serum ferritin among Australian adults by age and sex. Further, the relationships of various social, lifestyle and health factors with serum ferritin concentrations were explored. DESIGN: A total of 1634 adults aged60 drinks/month, and females aged<50 years who were obese. Lower serum ferritin concentrations were found only among females aged<50 years, with higher education attainment. In multivariable analysis, only the association between higher serum ferritin and obesity was consistent across age-sex groups and statistically significant. CONCLUSION: Iron deficiency may be a problem among Australian females of reproductive age. Further research is needed to identify the determinants of low iron concentrations in younger females and elevated concentrations of serum ferritin in males and older females in order to develop preventive measures.     

上海市杨浦区小学生及教师、家长的伤害认知现状分析

目的了解上海市小学生、学生家长和教师对伤害知信行情况,为开展伤害预防控制工作提供依据。方法分层整群抽取杨浦区小学1~4年级学生2720名,学生家长2610名和教师96名,采用问卷调查学生、教师和家长的伤害知信行情况等。结果上海市小学生、学生家长和教师对伤害有一定认知,但24.2%的学生、10.4%的教师和12.4%的家长不认同“伤害是可以预防的”。对学生、家长和教师的伤害防治知识系统培训比较缺乏,不少小学生在实际生活中仍具有一定的危险行为,部分教师和家长对孩子的安全教育和伤害防治相关措施还不足。结论社会相关部门应进一步加强对学生、教师和家长的伤害防治宣教工作,并运用健康促进的手段,促进学生、教师和家长主动采取安全行动,防止儿童伤害。     

The potential for walkability to narrow neighbourhood socioeconomic inequalities in physical function: A case study of middle-aged to older adults in Brisbane,Australia

Residents of disadvantaged neighbourhoods have poorer physical function than their advantaged counterparts, although the reasons for this remain largely unknown. We examined the moderating effects of walkability in the relationship between neighbourhood disadvantage and physical function using 2013 cross-sectional data from 5115 individuals aged 46–72 living in 200 neighbourhoods in Brisbane, Australia. The relationship between neighbourhood disadvantage and physical function differed by levels of walkability: positive associations as levels of walkability increased for those living in more disadvantaged neighbourhoods, and no difference for those living in more advantaged neighbourhoods. Further work is required to better understand the underlying mechanisms.     

Years of life lived with and without dementia in Australia, 2004–2006: a population health measure

Objective: To estimate the fraction of remaining life lived with and without dementia among Australian males and females at later life. Method: Analysis was performed by applying the life table technique that integrates mortality and morbidity statistics to derive a single population health indicator. Observed prevalence rates were used to calculate life expectancy with dementia. Results: At the age of 65 years, males are expected to live an additional 18 years, of which 6% would be lived with dementia. Females surviving to 65 years, are likely to live a further 22 years, 9% of which is expected to be lived with dementia. At the age of 85 years, males live a further six years; one‐sixth of this life spent with dementia. Females surviving to this age would live an additional seven years, with one‐fourth of that life with dementia. The portion of life lived with dementia out of total remaining years of life increases with age at the rate of 20 to 30% every five years beyond the age of 65. Conclusion. The extension of life expectancy is associated with increased duration of life lived with dementia. As females live longer than males, they experience a greater impact of dementia.