基于集中指数和水平不平等指数的卫生服务利用公平性研究 ——以上海市不同收入水平居民的CHNS数据分析为例

目的基于集中指数(CI)构建水平不平等指数(HI),分析不同经济水平的上海居民卫生服务利用的水平公平性,发现卫生资源配置存在的问题。方法在标准化卫生服务需求估计的基础上,采用基于CI的方法,使用中国健康营养调查(CHNS)上海地区的调查数据,测算卫生服务利用的水平公平性。结果样本人群的实际卫生服务利用、标准化卫生服务需求的CI分别为0.056,3和0.040,8,卫生服务的HI为0.015,5。在实际利用和实际需求方面,医疗服务具有亲富人的不平等性,并且卫生服务利用实际上更好地满足了高收入群体的卫生服务需求。医疗保险补偿前,不同收入组人群医疗费用的CI为-0.060,0,补偿后为-0.104,3;补偿前医疗费用主要集中于低收入人群,补偿后医疗费用的分布比补偿前更加集中于低收入人群,不公平程度有所增加。结论卫生资源配置还不能够真正满足居民的卫生服务需求,存在水平不平等。卫生服务利用实际上更好地满足了高收入群体的卫生服务需求。居民医疗保险虽然能从整体上降低居民的疾病经济负担,但未能提高医疗费用支出的公平性。在设计医疗保健系统体制时,应倾向于提高低收入居民医疗服务利用的可及性,更好地满足低收入居民由于健康因素产生的医疗服务需求,提高居民卫生服务利用的水平公平性。     

医学生思政课教学实践与研究——以党的二十大精神融入《习近平新时代中国特色社会主义思想概论》课为例

开展医学生思政课程教学研究,在坚持落实党的二十大精神融入《习近平新时代中国特色社会主义思想概论》课的前提下,通过文献研究、问卷调查和专题访谈等方式方法,归纳和总结出其理论内容融入医学生思政课的必要性、可行性和教学难点;并结合实际情况,积极开展教学实践与探索。同时,总结了将党的二十大精神融入医学生思政课的实践路径和教学方法,以及分析和研究了其对医学生思想政治素质的影响。     

开展小康社会"健康素质指数"的研究及意义

在党的十六大报告中，首次将全民族健康素质的明显提高列入全面建设小康社会的奋斗目标之一。“健康素质指数”是一个国家或地区人群健康状况的综合反映，也是小康社会的重要标志之一。国内外尚未见开展此项研究的报告。开展“健康素质指数”的研究，包括确定健康素质的概念、内涵的科学界定，健康素质的相关评价指标的筛选，构建“健康素质指数”的理论体系及数学模型，制定“健康素质指数”的评价依据和程序，用“健康素质指数”评价和预测各地建设小康社会的水平和进程。     

Attraction to Sexual Violence Towards Women,Sexual Abuse of Children,and Non-Sexual Criminal Behavior: Testing the Specialist vs. Generalist Models in Male College Students

A sample of 492 college men anonymously completed an expanded version of the Sexual Experiences Survey, the revised Attraction to Sexual Aggression Scale, and the Marlowe-Crowne Social Desirability Scale Short Form to investigate the relations among perpetration of sexual violence (including rape and sexual assault), attraction to sexual violence, attraction to childhood sexual abuse, and attraction towards other crimes while controlling for the impact of social desirability. Analyses indicated that attractions towards sexual violence, general criminality, and childhood sexual abuse were all significantly interrelated. In addition, sexual assault perpetrators reported higher levels of all three types of attraction as compared to nonperpetrators whereas rape perpetrators reported higher levels of attraction to sexual aggression and criminality. Clinical and research implications are discussed.     

Sexual behaviour, history of sexually transmitted diseases, and the risk of prostate cancer: a case-control study in Cuba

BACKGROUND: The relationship between the risk of prostate cancer and sexual activity and history of sexually transmitted diseases was investigated in a case-control study conducted in Cuba aimed at assessing the effect of lifestyle and environmental factors, as well as hormonal and genetic factors, on the occurrence of this disease. METHODS: During the period 1998-2000, all men up to 84 yr old with newly diagnosed, cytologically and/or histologically confirmed prostatic cancer who were resident in Havana City were identified in nine major hospitals in the area. Controls were resident in the same city, frequency-matched by age (+/-5 years) and hospital. The study included 273 cases and 254 controls. Information was obtained through an interview. RESULTS: The risk of prostate cancer was increased among men with a history of venereal disease (odds ratio = 1.7, 95% CI = 1.1-2.5). A higher frequency of cases reported having had sex with prostitutes, although the estimate of relative risk did not reach statistical significance. Similarly, a nonsignificant positive association was found with the number of female sexual partners. A significant increased risk was observed in subjects who reported having sexual intercourse more than 7 times per week compared with those who reported a weekly frequency of 3 times or fewer (odds ratio = 2.1, 95% CI = 1.2-3.7). Moreover, a significant trend was demonstrated. CONCLUSIONS: The study supports the hypothesis that an infectious factor related to sexual behaviour could be involved in the occurrence of prostate cancer. A role for hormonal factors related to sexual activity cannot be ruled out.     

Social capital and lack of belief in the possibility to influence one's own health: a population-based study

OBJECTIVES: To study the impact of social capital (social participation and trust) on lack of belief in possibility to influence health. METHODS: The Scania 2000 public-health survey is a cross-sectional, postal questionnaire study including 13,604 persons aged 18-80 years which was conducted in 2000 by the regional healthcare authorities in Region Sk?ne, southern Sweden, to investigate health-related risk factors in the population. A logistic regression model was used to investigate the association between social capital and lack of belief in possibility to influence health. The multivariate analyses analysed the importance of confounders on the differences in lack of belief in possibility to influence health according to the social capital variables. RESULTS: In total, 31.0% of all men and 33.5% of all women lack belief in the possibility to influence their own health. Lack of belief in possibility to influence health was positively associated with both low social participation and low trust, although stronger for social participation than for trust. CONCLUSIONS: Low levels of social capital, particularly low social participation, is positively associated with lack of belief in the possibility to influence one's own health.     

哈尔滨市中医药进社区现状分析与对策研究

调查哈尔滨市南岗区、道里区、道外区、香坊区和平房区现有120个社区医院或社区卫生服务中心,分析中医药进社区现状,提出存在的问题及相应对策。     

A comparative study of the serological response to Japanese encephalitis vaccine in HIV-infected and uninfected Thai children

We report a prospective study of mouse brain derived inactivated Japanese encephalitis (JE) vaccine, given in 3-dose EPI program to human immune deficiency virus (HIV)-exposed Thai infants. 18 HIV-infected receiving antiretroviral therapy with median baseline CD4 of 33.1%, and 92 HIV-uninfected children were studied. All but one HIV-infected child seroconverted after the second dose. The geometric mean titers (GMTs) 3 months after the second and third doses in HIV-infected vs HIV-uninfected children were 247 vs 938 (p = 0.022), and 2273 vs 24069 (p = 0.009), respectively. Urticaria or angioedema found in 4% and 6% in HIV-infected and -uninfected children, respectively (p = 1.0). The vaccine was safe and immunogenic but antibody response in HIV-infected children was not as high as in uninfected children.     

Association between parental history of diabetes and the incidence of type 2 diabetes mellitus differs according to the sex of the parent and offspring's body weight: A finding from a Japanese worksite-based cohort study

ObjectiveTo investigate differences in the association of parental history of diabetes with the risk of type 2 diabetes mellitus (T2DM) in the offspring according to the sex of the parent and the offspring's body weight.MethodsA prospective cohort study of 4446 middle-aged non-diabetic Japanese men and women were followed in Aichi Prefecture, central Japan, from 2002 to 2011. Subjects were categorized by their self-reported parental history of diabetes (“no parental history,” “father only,” “mother only,” and “both”). The association of parental history of diabetes and incidence in the offspring was examined according to overweight status adjusted for age, sex, birth weight, smoking, alcohol consumption, physical activity, total energy intake, body mass index, and number of metabolic syndrome components.ResultsDuring follow-up (median 8.9 years), 277 subjects developed T2DM. Parental history of diabetes was positively associated with T2DM incidence. However, stratified analysis by overweight status revealed that only maternal history was associated with increased T2DM incidence in non-overweight subjects (hazard ratio = 2.35, 95% confidence interval: 1.41–3.91). While in overweight subjects, paternal history was significantly associated with higher T2DM incidence (hazard ratio = 1.98, 95% confidence interval: 1.19–3.28).ConclusionsOur results suggest that parental history of diabetes mellitus is associated with the incidence of T2DM in offspring differently according to the sex of the affected parent and the offspring's body weight.