Clean Spaces,Community Building,and Urban Stage: the Coproduction of Health and Parks in Low-Income Neighborhoods

Green zones are potential contributors to health by mitigating disparities between low- and high-income neighborhoods. Against the background of different discourses about city parks—parks as restorative environments, parks as enabling places, and parks as sites for encounters between strangers—we ethnographically studied the coproduction of green spaces and health within low-income neighborhoods. We found three competing notions of urban green, each tied to different notions of neighborhood well-being. Parks as “clean spaces” create expectations of order and peace; parks as places of the community are related to play and activities; and parks as urban stage foster interactions between strangers. By generating experiences that encompass different conceptions of health, citizen-led events can contribute to a shift in the understanding of parks as sites of neighborhood decline to parks as places of hope and new beginnings.     

德国柏林Pflgewerk养老机构学习见闻分享

2019年9—12月,笔者参与了苏州大学与德国柏林Pflgewerk养老机构针对失能老年人居家照护课程研发与智慧化养老的交流项目,在学习与交流期间,德国完善的居家照护体系,先进适老辅具的研发与运用,系统规范的照护员培训课程,浓厚的人文关怀气氛与多学科团队合作的安宁疗护中心令笔者印象深刻。本文结合学习交流活动的亲身经历,...     

综合干预后血脂达标率调查

目的探讨综合干预措施对老年人血脂异常状况改善的价值。方法采用国际标准化心血管流行病学调查方法,对辖区内离退休老干部进行心血管危险因素调查;对该人群进行健康教育,并对每一个体进行危险评估、个体化用药指导,并跟踪随访。结果(1)本研究人群是多重危险因素高度聚集的心血管疾病群体,冠心病及等危症者占69.81%;(2)经过3年的综合干预,他汀类药物的服用率由14.48%上升到22.32%;高TC血症治疗达标率由27.00%上升至63.78%;高LDL-C控制率由19.79%上升到63.65%;TC与LDL-C的达标率都有显著增高(P<0.01);TG的达标率无显著变化。结论健康教育和根据危险分层确定个体化治疗方案相结合的综合干预,能够明显提高高胆固醇血症老年患者的血脂达标率。     

健康教育干预在慢性病防治中的作用

目的探讨健康教育干预在慢性病防治中的作用。方法根据干部体检结果,对该人群采取了健康教育干预,尤其对其中确诊的812例高血压、753例心电图异常、691例高脂血症、289例糖尿病、218例糖耐量异常及143例高尿酸血症患者(以上称慢病跟踪组)进行了规范化管理和治疗,2年后复检,并对有关项目的检查进行对比。结果干预后该人群高血压、心电图异常、高脂血症、糖尿病及糖耐量异常的发生明显下降,χ2值分别为7.32、4.36、7.53、7.63、8.35(P<0.01、0.05);慢病跟踪组通过行为加药物的干预性治疗,高血压、高脂血症、糖尿病等平均控制达标率为80%以上。结论健康教育干预是预防慢性病的重要策略和有效手段。     

类风湿性关节炎患者健康相关生命质量评价及其影响因素

目的 探讨类风湿性关节炎（RA）住院患者健康相关生命质量（HRQoL）评分及其影响因素。 方法 采用欧洲五维度五水平健康量表（EQ-5D-5L）及自编问卷对 2023 年 4~9 月安徽中医药大学第一附属医院风湿免疫科收治的 200 例 RA 住院患者进行HRQoL 调查,EQ-5D-5L 量表中健康描述系统及视觉模拟标尺（EQ-VAS）分别用于测量 RA 患者健康效用值及整体健康状态,采用单因素分析、Tobit 多因素回归分析影响 RA 患者 HRQoL 的因素。 结果 共收集 190 份有效问卷,有效回收率 95%。RA 患者健康效用值为（0.77±0.25）,EQ-VAS 评分为（76.44±43.65）分,其健康问题多集中于“行动能力”和“疼痛或不适”两个维度。Tobit 多因素回归分析显示,文化程度低（P=0.042,95%CI：0.032~0.143）与吸烟（P=0.013,95%CI：-0.154~-0.019）是 RA 患者 HRQoL 的危险因素。 结论 RA患者 HRQoL 与 EQ-VAS 较一般人群相比情况尚可,但仍存在健康效用值较低的问题,其中文化程度低与吸烟的患者 HRQoL 较差。     

多方式下延续性护理对慢性非萎缩性胃炎患者出院后健康素养、生活质量和复诊率的影响

目的研究多方式下延续性护理对慢性非萎缩性胃炎(CNAG)患者出院后健康素养、生活质量和复诊率的影响。方法选择本院2018年10月至2019年6月诊治的94例CNAG患者作为研究对象,采用信封随机法将患者均分为延续组和常规组,各47例,前者给予多方式下延续性护理,后者给予常规护理。均干预6个月.,比较两组患者健康素养、生活质量以及复诊率。结果干预后两组患者健康素养分值均较干预前显著上升.,延续组患者上升幅度较常规组更显著(P<005);延续组.患者生理功能、生理职能、活力、精神健康、躯体疼痛、总体健康评分均显著高于常.规组(P<005),而情感职能、社会功能与常规组相比差异不显著(P>005);延续组患者复诊率显著高于常规组,但再就诊率与常规组相比差异不显著(P>005)。结论多方式延续性护理可有效提高CNAG患者的健康素养和生活质量,提高复诊率。     

Prevalence and comorbidities of bronchiolitis in adults: A population-based study in South Korea

Bronchiolitis generally refers to inflammation and/or fibrosis of the non-cartilaginous small airways located approximately from the 8th airway generation down to the terminal and respiratory bronchioles. In contrast to young children, the frequency of small airway infection in adult bronchiolitis appears less frequent and a number of other pathophysiological conditions have been implicated in adult bronchiolitis. However, little information is available on the exact medical burden of bronchiolitis such as its prevalence and comorbidities in the adult population. The aim of this study is to elucidate the prevalence and comorbidities of bronchiolitis. We used the Korea National Health Insurance Service-National Sample Cohort, which provides data for 1,000,000 individuals out of the entire population by 2% stratified random sampling according to age, sex, residential area, and level of household income. We defined the cause of bronchiolitis other than acute infection as a patient with diagnostic code J448 or J684 and over 20 years of age who visited a clinic or hospital in South Korea. Then, 1:1 propensity score matching was performed to define a non-bronchiolitis (control) group to compare the comorbidities and mortality in the 2 groups. The overall prevalence of bronchiolitis was 688 cases/1,000,000 population during the study period (95% confidence interval, 625–751). The most common comorbid clinical condition in adults with bronchiolitis was rhinitis (52.3%), followed by bronchial asthma (52.23%), hypertension (43.69%), gastroesophageal reflux disease (30.56%), sinusitis (28.72%), diabetes (22.77%), and osteoporosis (17.85%). Other common bronchiolitis-associated comorbidities were cerebrovascular disease (16.86%), angina (14.37%), peripheral vascular disease (13.42%), congestive heart failure (11.9%), and malignancy in any organ (10.6%). Healthcare costs for bronchiolitis increased steeply during the same period. Malignancy in any organ was the leading cause of mortality in the patient group, followed by bronchiolitis itself. Further larger prospective multiethnic cohort studies should be carried out in the near future.