2012年中国公民健康素养监测方案简介

  目的  探讨自报慢性病患病与健康素养水平的关系,为预防控制慢性病和提高居民健康水平提供科学依据。  方法  2015年5月 — 12月采用分层多阶段与人口规模成比例抽样（PPS）方法,在辽宁省抽取15～69岁常住人口使用统一编定的问卷进行调查,并应用多因素logistic回归分析自报慢性病患病情况与健康素养水平的相关性。  结果  辽宁省居民自报慢性病患病率为22.08 %,其中城市22.72 %,农村21.37 %,差异有统计学意义（P < 0.05）。多因素logistic回归分析显示,城市居民,随着年龄组升高,居民自报慢性病患病率升高（OR = 2.002）;文化程度越高,居民自报慢性病患病率下降（OR = 0.881）;与公务员相比,学生的自报慢性病患病率低（OR = 0.123）;具备传染病防治素养的居民自报慢性病患病率较低（OR = 0.751）。农村居民,女性自报慢性病患病率高于男性（OR = 1.380）;随着年龄组升高,居民自报慢性病患病率增加（OR = 1.950）;教师、医务人员、学生、工人的自报慢性病患病率较公务员低（OR = 0.491、0.489、0.402、0.446）;具备健康信息素养的居民自报慢性病患病率较低（OR = 0.776）。  结论  提高居民,尤其是农村男性的自我保健意识,提高慢性病检出率,以老年人、文化程度较低者为重点人群开展针对性的健康教育干预措施,预防和控制慢性病的发生。     

作为社会转型表征的中国城市新移民

  目的  构建城市新移民健康相关社会资本评价指标体系,作为进一步评价城市新移民健康相关社会资本的评估工具。  方法  采用文献法和专题小组讨论,初步形成城市新移民健康相关社会资本评价指标体系框架,使用Delphi法遴选评价指标,应用层次分析法确定指标权重。  结果  两轮专家咨询的积极系数分别为97.1 % 和94.1 %,权威系数为0.85,协调系数分别为0.14和0.27（P < 0.05）。结合界值法和专家意见删减调整后最终建立了包括个体、家庭、社区、工作单位和宏观社会在内的5个一级指标、23个二级指标、50个三级指标及其权重构成的指标体系,权重分别为0.15～0.28、0.13～0.36、0.18～0.55。  结论  所构建评价指标体系具有较好的科学性和适用性,可为城市新移民健康相关社会资本的测量和评价提供参考。     

从全球视角看中国脑卒中疾病负担的严峻性

  目的  了解福建省宁德市社区居民脑卒中高危人群筛查结果,为该市居民的脑卒中筛查及防治提供参考依据。  方法  于2015年1月 — 2018年12月采用整群抽样方法在福建省宁德市蕉南社区、漳湾社区、霍童社区和九都社区抽取18 039名 ≥ 40岁常住居民进行问卷调查和体格检查。  结果  宁德市筛查的18 039名社区居民中,检出脑卒中高危人群2 438人,高危人群检出率为13.52 %;男性居民高危人群检出率为16.39 %,高于女性居民高危人群检出率的10.54 %（χ² = 132.05,P < 0.001）;年龄40～49、50～59、60～69、70～79和 ≥ 80岁居民脑卒中高危人群检出率分别为2.76 %、9.38 %、15.18 %、29.41 %和31.81 %,差异有统计学意义（χ² = 1 282.84,P < 0.001）;脑卒中高危人群高危风险因素所占比例从高到低依次为高血压（74.69 %）、缺乏运动（69.77 %）、吸烟（41.35 %）、血脂异常（36.22 %）、糖尿病（28.14 %）、明显超重或肥胖（17.56 %）、脑卒中家族史（9.19 %）、房颤或瓣膜性心脏病（1.31 %）,不同性别和年龄高危人群高危风险因素分布差异均有统计学意义（均P < 0.05）。  结论  福建省宁德市社区居民脑卒中高危人群检出率相对较低,男性和 ≥ 60岁居民脑卒中高危人群检出率较高,高危人群的前3位高危风险因素依次为高血压、缺乏运动和吸烟。     

新型冠状病毒肺炎确诊患者及隔离留观者心理状况的影响因素研究

  目的  了解湖北省居民在新冠肺炎疫情期间的心理健康状况,为进行居民心理指导提供科学依据。  方法  于2020年2月10 — 12日采用滚雪球抽样方法在湖北省抽取1 157名居民进行心理健康问卷调查。  结果  湖北省1 157名居民中,有16.51 %的居民有焦虑症状,且不同年龄、文化程度、婚姻状况和职业居民焦虑状况不同（均P < 0.05）;有51.51 %和13.74 %的居民有中度和高度恐惧,且不同性别和年龄居民恐惧状况不同（均P < 0.05）;有20.22 %和73.38 %的居民对战胜疫情有中度和高度信心,且不同性别、年龄和文化程度居民战胜疫情的信心状况不同（均P < 0.05）;有35.87 %和25.24 %的居民中度和重度担忧因此次疫情而遭受歧视,且不同性别、年龄、文化程度、婚姻状况、职业和居住地居民担心受歧视状况不同（均P < 0.05）。  结论  湖北省居民的心理健康状况因此次新冠肺炎疫情受到不同程度的影响,且不同性别、年龄、文化程度、婚姻状况、职业和居住地也会影响其心理健康状况,因此对湖北省居民应给予早期的有针对性的心理干预措施。     

潍坊市城区双向转诊制度实施情况及政策建议

目前,在社区卫生服务双向转诊制度实施中还面临很多障碍,要使双向转诊制度落到实处,真正发挥它应有的作用,仍然存在许多不尽人意的地方。文章通过从政府及其有关部门角度、患者角度、医疗保险机构角度、媒体角度等多方面,提出了促进双向转诊的主要措施。     

Area of residence and alcohol‐related mortality risk: a five‐year follow‐up study

Aims To examine differences in alcohol‐related mortality risk between areas, while adjusting for the characteristics of the individuals living within these areas. Design A 5‐year longitudinal study of individual and area characteristics of those dying and not dying from alcohol‐related deaths. Setting The Northern Ireland Mortality study. Participants A total of 720 627 people aged 25–74, enumerated in the Northern Ireland 2001 Census, not living in communal establishments. Measurements Five hundred and seventy‐eight alcohol‐related deaths. Findings There was an increased risk of alcohol‐related mortality among disadvantaged individuals, and divorced, widowed and separated males. The risk of an alcohol‐related death was significantly higher in deprived areas for both males [hazard ratio (HR) 3.70; 95% confidence interval (CI) 2.65, 5.18] and females (HR 2.67 (95% CI 1.72, 4.15); however, once adjustment was made for the characteristics of the individuals living within areas, the excess risk for more deprived areas disappeared. Both males and females in rural areas had a reduced risk of an alcohol‐related death compared to their counterparts in urban areas; these differences remained after adjustment for the composition of the people within these areas. Conclusions Alcohol‐related mortality is higher in more deprived, compared to more affluent areas; however, this appears to be due to characteristics of individuals within deprived areas, rather than to some independent effect of area deprivation per se. Risk of alcohol‐related mortality is lower in rural than urban areas, but the cause is unknown.     

EDITORIAL

No abstract available for this article.     

The Portal Project

SUMMARY

Palladia, Inc. is a not-for-profit, multi-service agency, located in New York City, serving primarily African-American and Latino communities. Palladia's Portal Project, in collaboration with the evaluation team from Hunter College School of Social Work (HCSSW), participated in the national Women, Co-Occurring Disorders and Violence study. We studied 270 women with co-occurring issues of alcohol and other drug (AOD) problems and mental illness, who had histories of violence, and were high end users of service. Palladia built an integrated system of care and implemented a comprehensive trauma-informed intervention that is designed to put trauma and safety first to assist women in remaining in treatment. Primacy of trauma in the early stages of treatment constitutes a major philosophical shift within the traditional residential drug treatment setting. The focus of the engagement and treatment process is on the role of trauma in the woman's life and its relationship to patterns of AOD abuse and mental illness. Another key feature of the Portal model is the emphasis on normalizing the adaptations which the women have made in response to interpersonal traumatic life events. The women feel less stigmatized and isolated. They are encouraged to see their former coping and adaptive behaviors as strengths rather than maladaptive weaknesses, deficiencies or character flaws. Support for the women in their parenting and family roles and attention to their individual perceptions of culture are also part of the intervention. Portal blends service intervention, policy development, research, and evaluation for effective service delivery. The collaborative work of this project has produced a replicable model that configures specific direct service enhancements and service system improvements, using the active involvement of consumers, practitioners, service providers and policy makers.     

Behavioral Self-Management

While behavioral treatments have been increasingly utilized with older patients, they have almost entirely involved operant, rather than self-management, approaches. In the present paper, differences between operant and self-control behavioral approaches are discussed. A case example is presented of the successful use of a behavioral self-management treatment with an elderly patient with severe agitation. The potential utility of the self-management approach with older patients is discussed.     

Pro Re Nata Drug Use in Nursing Home Residents: A Systematic Review

Objectives

In addition to routinely administered long-term medication, complex drug regimens of nursing home residents often include as needed or pro re nata (PRN) medication. However, there has been no systematic evaluation of the frequency and concomitants of PRN medication in nursing homes. The main objective of this systematic review was to provide a current assessment of PRN drug use in nursing homes.