[Effect of Intergenerational Support from Children on Older Adults' Healthcare Seeking Behaviors].

Objective: To investigate the impact of intergenerational support from children on older adults' healthcare seeking behaviors and to provide suggestions to help promote sensible healthcare seeking behaviors in older adults. Methods: Based on the data from the 2016 baseline data and the 2018 national tracking survey of China Family Panel Studies (CFPS), a total of 5690 respondents aged 60 years and older with surviving children were selected for the study. Logistic regression was used to analyze the effect of children's intergenerational support on older adults' healthcare seeking behavior. Results: The probability of seeing a doctor in the last two weeks was relatively higher among older adults whose children provided financial support (odds ratio [ OR]=1.129, 95% confidence interval [ CI]: 1.004-1.271, P<0.05), but the effect of whether children provided financial support on one-year hospitalization was not significant ( P>0.05). Daily care support from children contributed positively to both seeing a doctor in the last two weeks and one-year hospitalization among older adults ( OR=1.155, 95% CI: 1.021-1.307, P<0.05; OR=1.204, 95% CI: 1.053-1.378, P<0.01), while whether or not older adults saw their children daily had no significant effect on either seeing a doctor in the last two weeks or one-year hospitalization among older adults ( P>0.05). Conclusion: Intergenerational support from children has an important influence on the healthcare seeking behaviors of older adults. The advantageous role of children's intergenerational support should be made full use of. In addition, formal channels of social support should be improved to alleviate the pressure on children to provide intergenerational support and suggestions should be provided to promote sensible healthcare seeking behaviors in older adults, so as to further improve the overall health level of older adults.

The effects of neighborhood socioeconomic status on ADL/IADL among Chinese older adults-neighborhood environments as mediators.

Background: There have been few consistencies in the effects and pathways of neighborhood socioeconomic status (SES) on functional limitations. This study aimed to investigate whether neighborhood socioeconomic status influences ADL/IADL in older residents in China through the neighborhood built environment and social environment. Methods: Activities of daily living/IADL were assessed in a sample of 5,887 Chinese individuals aged 60 or older, utilizing data obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS 2011). Neighborhood SES was measured by the neighborhood per-capita net income. Neighborhood built environment was measured by the security resources, motion resources, living resources, service resources for older adults, and medical resources of neighborhood. Neighborhood social environment was measured by the organizations, unemployment subsidies, minimum living allowance, subsidies to persons older than 65, and pensions to persons older than 80 of the neighborhood. The two-level logistical regression model and multilevel structural equation model (MSEM) were used. Results: The rate of ADL/IADL loss among Chinese older adults aged 60 and above in 2011 were 32.17 and 36.87%, respectively. Neighborhood SES was significantly associated with ADL/IADL in older adults. Compared with the respondents living in communities with lower SES, those living in communities with higher SES possessed better ADL (ß = -0.33, p < 0.05) and IADL (ß = -0.36, p < 0.05) status. The path of neighborhood socioeconomic status on ADL was completely mediated by the neighborhood built environment (ß = -0.110, p < 0.05) and neighborhood social environment (ß = -0.091, p < 0.05). Additionally, the effect of neighborhood socioeconomic status on IADL was fully mediated by the neighborhood built environment (ß = -0.082, p < 0.05) and neighborhood social environment (ß = -0.077, p < 0.05). Conclusion: Neighborhood SES was significantly correlated with ADL/IADL through the neighborhood environment. Improving the ADL/IADL status of older adults residing in low socioeconomic neighborhoods requires enhancing the built and social environment by provisioning additional neighborhood resources.

Comparative assessment of reported symptoms of influenza, respiratory syncytial virus, and human metapneumovirus infection during hospitalization and post-discharge assessed by Respiratory Intensity and Impact Questionnaire.

BACKGROUND: The hospitalized acute respiratory tract infection (HARTI) study used the Respiratory Intensity and Impact Questionnaire (RiiQ™) Symptom Scale, derived from FluiiQ™, to assess and compare the burden of respiratory infection symptoms for patients with influenza, respiratory syncytial virus (RSV), and human metapneumovirus (hMPV) infection, with or without core risk factors (CRF) (age ≥65; chronic heart, renal, obstructive pulmonary disease; asthma). METHODS: This was a prospective cohort study in adult patients hospitalized with acute respiratory tract infection (40 centers, 12 countries) during two consecutive influenza/RSV/hMPV seasons (2017-2019). The RiiQ™ Symptom Scale and EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) were assessed by interview at two timepoints during hospitalization and at 1, 2, and 3 months post-discharge. RESULTS: Mean lower respiratory tract (LRT) symptom scores were higher for RSV and hMPV participants compared to influenza at 48 h after enrollment/early discharge (p = 0.001) and 3 months post-discharge (p = 0.007). This was driven by LRT symptoms, including shortness of breath (SOB) (p < 0.01) and wheezing (p < 0.01) during hospitalization, and SOB (p < 0.05) and cough (p < 0.05) post-discharge. Participants with CRF reported more moderate-to-severe SOB (p < 0.05) and wheezing (p < 0.05) compared to CRF(-) participants post-discharge. EQ-5D-5L scores were moderately associated with RiiQ™ LRT and systemic symptoms domains. CONCLUSIONS: Results from the HARTI study suggest that in the study population, LRT symptoms were more severe for RSV and hMPV groups and for patients with CRF. RiiQ™ Symptom Scale scores shows a moderate association with EQ-5D-5L indicating that the RiiQ™ may provide useful insights and offer advantages over other measures for use in interventional RSV adult clinical studies.

[Correlation Study of Community Social Environment and Self-Rated Health of Middle-Aged and Older Adults].

OBJECTIVE: To analyze the impact of the social environment of a community on the self-rated health of middle-aged and older adults living in the community, and to provide a basis for building favorable community social environment that promotes the health of middle-aged and older adults. METHODS: Using the community and individual survey data from China Health and Retirement Longitudinal Study (CHARLS) done in 2011, 7822 middle-aged and older adults living in 397 communities were selected as the subjects of the study. Community social environment under study included community socioeconomic status, community social security and community services. Self-rated health was measured with a five-level score. A three-level hierarchical generalized linear model (HGLM) was used to analyze the impact of community social environment on the self-rated health of middle-aged and older adults. RESULTS: The proportion of subjects who reported self-rated poor health was 28.8%. According to the results of the three-level HGLM, the self-rated health of middle-aged and older adults showed differences at both the city and the community levels, and the variance reduction ratio reached 35.71% at the community level. The self-rated health status of residents in the communities with medium and high net per capita income was better than that in the communities with low net per capita income ( OR=0.84, P<0.05; OR=0.70, P<0.05). The self-rated health status of residents in the communities with secondary and higher education levels was better than that in the communities with low education level ( OR=0.78, P<0.05; OR=0.73, P<0.05). The self-rated health of middle-aged and older adults in the communities with unemployment subsidies was much better ( OR=0.77, P<0.05). The self-rated health status of middle-aged and older adults with chronic diseases was worse ( OR=4.46, P<0.05). Middle-aged and older adults living in cities had better self-rated health status ( OR=0.67, P<0.05). CONCLUSION: Community socioeconomic status and community unemployment subsidy are positively correlated with the self-rated health of middle-aged and older adults living in the community. It is necessary to pay special attention to the health status of middle-aged and older adults in communities of low socioeconomic status, improve unemployment insurance policies, and promote the health of middle-aged and older adults.

The Impact of Family Income on Body Mass Index and Self-Rated Health of Illiterate and Non-illiterate Rural Elderly in China: Evidence From a Fixed Effect Approach.

Background: Rural communities worldwide are experiencing the most significant levels of aging. Most rural elderly have no stable pension, and leading family income plays an indispensable role in the life security of rural elderly. This study aims to investigate whether the association between annual family income per capita and body mass index (BMI) and self-rated health (SRH) in rural elderly is moderated by education during fast economic development. Methods: We chose the fixed-effects model to analyze the impact of the annual family income per capita change on BMI and SRH based on a large, nationally representative longitudinal dataset of rural respondents aged above 60 of the China Family Panel Studies (CFPS) from 2010 to 2018. Results: Six hundred and fifty-eight were eligible for inclusion in our analysis in CFPS. The median age of participants was 65 years in 2010, and 379 (57.60%) participants were male. Self-rated health increased with higher the logarithmized family income per capita among the rural illiterate elderly (ß = 0.0770; 95% CI = 0.0065-0.1473). Body mass index increased with higher the logarithmized family income per capita among the rural elderly (ß = 0.1614, 95% CI: 0.0325-0.2903), and it was more evident among the illiterate elderly (ß = 0.2462, 95% CI: 0.05519-0.4372). Conclusion: Family income has an impact on BMI and SRH moderated by education level among rural elderly in China. These results contribute to developing more targeted strategies in the context of a developing country. In addition, it also reminds us to consider the differences in the educational level of the elderly in rural areas when examining the relationship between family income and health.

Assessment of the anti-CD40 antibody iscalimab in patients with primary Sjögren's syndrome: a multicentre, randomised, double-blind, placebo-controlled, proof-of-concept study.

BACKGROUND: Primary Sjögren's syndrome is an autoimmune disease that presents as dryness of the mouth and eyes due to impairment of the exocrine glands. To our knowledge, no systemic therapies for primary Sjögren's syndrome have shown efficacy. CD40-CD154-mediated T cell-B cell interactions in primary Sjögren's syndrome contribute to aberrant lymphocyte activation in inflamed tissue, leading to sialadenitis and other tissue injury. Therefore, we investigated the safety and preliminary efficacy of iscalimab (CFZ533), a novel anti-CD40 monoclonal antibody, in patients with primary Sjögren's syndrome. METHODS: This multicentre, randomised, double-blind, placebo-controlled, proof-of-concept study took place at ten investigational sites across Europe (UK, n=4; Germany, Switzerland, and Hungary, n=1 each) and the USA (n=3). Eligible patients were aged 18-75 years and fulfilled the 2002 American European consensus group diagnostic classification criteria for primary Sjögren's syndrome. In the double-blind phase of the trial, patients were randomly assigned (2:1) via computer-generated unique randomisation numbers to receive subcutaneous iscalimab (3 mg/kg) or placebo at weeks 0, 2, 4, and 8 (cohort 1) or intravenous iscalimab (10 mg/kg) or placebo at weeks 0, 2, 4, and 8 (cohort 2). Randomisation was stratified according to baseline intake of oral corticosteroids. At week 12, patients in both cohorts received open-label iscalimab (same dose and route) for 12 weeks. The primary objectives of the study were to assess the safety, tolerability, and efficacy of multiple doses of iscalimab in the two sequential dose cohorts. Safety and tolerability were assessed by adverse events and efficacy of iscalimab versus placebo was assessed by clinical disease activity, as measured by the change in European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI) score after 12 weeks of treatment. Analyses were done on a per-protocol basis. The trial was registered with ClinicalTrials.gov, NCT02291029. FINDINGS: Between Oct 22, 2014, and June 28, 2016, we assessed 82 patients for eligibility (25 for cohort 1 and 57 for cohort 2). 38 patients were excluded because of ineligibility. In cohort 1, 12 patients were randomly assigned to receive either 3 mg/kg doses of iscalimab (n=8) or placebo (n=4), and in cohort 2, 32 patients were randomly assigned to receive either intravenous 10 mg/kg doses of iscalimab (n=21) or placebo (n=11). Adverse events were similar between iscalimab treatment groups and placebo groups, with adverse events occurring in all patients in cohort 1, and in 52% and 64% of the iscalimab and placebo groups, respectively, in cohort 2. Two serious adverse events were reported (one case of bacterial conjunctivitis in cohort 1 and one case of atrial fibrillation in cohort 2), which were unrelated to treatment with iscalimab. Intravenous treatment with iscalimab resulted in a mean reduction of 5·21 points (95% CI 0·96-9·46; one-sided p=0·0090) in ESSDAI score compared with placebo. There was no signficiant difference in ESSDAI score between subcutaneous iscalimab and placebo. INTERPRETATION: To our knowledge, this is the first randomised, placebo-controlled proof-of-concept study of a new investigational drug for primary Sjögren's syndrome that indicates preliminary efficacy. Our data suggest a role of CD40-CD154 interactions in primary Sjögren's syndrome pathology and the therapeutic potential for CD40 blockade in this disease should be investigated further. FUNDING: Novartis Pharma.

Association between social capital and quality of life among urban residents in less developed cities of western China: A cross-sectional study.

China has experienced rapid urbanization over the past several decades. Social capital is considered a vital human resource, and quality of life (QoL) is an important measure of human health embedded in a physical, mental, and social context. No studies have reported on the association between social capital and QoL in Chinese urban residents. We performed a cross-sectional study to investigate social capital in urban community residents of West China, and its relationship with QoL.Our study was carried out between June and July of 2015. A total of 1136 households were surveyed. The Chinese-translated version of the Short-Form Health Survey (SF-12) and social capital questionnaire were used to evaluate people's QoL and social capital. Associations between QoL and social capital were evaluated by 3 logistic regression analyses.A total of 1136 adult participants aged 18 years and older completed the questionnaire. Young residents were more likely to have lower second (SC2), third (SC3), and fourth (SC4) dimensions of social capital. Migrants and residents with higher education levels and high incomes showed lower SC1 and SC2 relative to other participants, and employed residents had relatively low SC1. Unmarried residents had lower SC2 and SC3. Without adjustment for potential confounding factors, participants with higher SC2 had higher average scores for mental components (MCS) of QoL [odds ratio (OR) = 1.48, 95% confidence interval (95% CI): 1.09-2.02], and the same was seen for SC3 (OR = 1.70, 95% CI: 1.24-2.34). After adjusting for socioeconomic status (SES) and risk factors, SC2 and SC3 were still significantly associated with MCS. Social capital was not significantly associated with physical components of QoL in any of the 3 logistic regression models.In conclusion, social capital is related to MCS of QoL, and increasing it may be an effective way to promote health.

Cross-sectional study of factors associated with community health centre use in a recently urbanised community in Chengdu, China.

OBJECTIVES: Public investment in community health centres (CHCs) has been increasing as a response to rapid urbanisation in China. The objectives of this study were: (1) to examine factors associated with CHC use among residents from a recently urbanised community in western China and (2) to describe satisfaction with CHC among users. DESIGN: Cross-sectional design. SETTING: A community recently converted to urban status with a newly constructed CHC in Southwest China. PARTICIPANTS: A random sample of 2259 adults in the Hezuo community in Chengdu, China, completed the survey in 2013. OUTCOME MEASURES: Trained staff interviewed study participants in their homes using structured questionnaires. The survey included questions regarding sociodemographics, health status, access to and usage of healthcare, health behaviours and CHC use. The Andersen's behavioural model of health service use was used to guide multivariable logistic regression modelling in identifying predisposing, enabling and need factors associated with the likelihood of using CHC. Descriptive statistics were used to describe residents' satisfaction with the CHC. RESULTS: A total of 71.8% of the respondents reported using the CHC during the past year. Factors influencing adults' CHC use included: gender, marital status, education level and knowledge of one's blood pressure (predisposing factors); annual household per capita income and walking time to the CHC (enabling factors) and self-rated health as well as physical activities (need factors). CHC users reported modest satisfaction across various aspects of the CHC. CONCLUSIONS: Neighbourhood CHC in urban areas provides important services to these residents living in a recently urbanised community. All three categories of factors in the Andersen model help explain the likelihood of CHC use. There is much room for improvement in CHC to enhance customer satisfaction. Future research is needed to improve access to CHCs and promote their use in urbanised populations with low to modest education.

Urban-rural disparity in utilization of preventive care services in China.

Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban-rural disparity in utilization of preventive care services in China, and determined how much of the urban-rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder-Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban-rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (-1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between urban and rural.

[Depressive Symptoms in the Mid- and Old-aged People in China].

OBJECTIVES: To determine the prevalence and determinants of depressive symptoms in the mid- and old-aged people in China. METHODS: Data were extracted from the 2013 China Health and Retirement Longitudinal Study (CHARLS),which containthe Center Epidemiologic Studies-Depression scale(CES-D). Binary logistic regression models were developed to identify factors associated with the prevalence of depression symptoms. These included socio-economic status of the respondents (gender, age, education),health-related factors (chronic diseases, disability, accident injury, and fall in recent two years),and family events over the past two years (deaths of a parent, spouse or child). RESULTS: About 31.9% of respondents had depressive symptoms, with a mean CES-D score of 8.0±4.9.Women and those who were younger than 75 years, widowed, resided in a rural area, had low levels of education, and suffered from multiple chronic conditions were more likely to have depressive symptoms than the others. CONCLUSIONS: High prevalence of depressive symptoms in the mid- and old-aged population in China is evident, which is associated with the health and socio-economic status of the population.

[Impact of urbanization on the residents' health service needs and utilization based on the urban and rural integration development].

OBJECTIVE: To explore the impact of urbanization on the residents' health service needs and utilization for the purpose of providing references for health making-decision by analyzing the difference of health service needs and utilization in semi-urban residents, urban residents and rural residents. METHODS: The residents in the three economic zones of Chengdu were selected by stratified ration sampling and interviewed with the questionnaire. RESULTS: The two-week morbidity rate, hospitalization rate, and non clinical visit rate of semi-urban residents were higher than those of other people, and the chronic disease prevalence rate of urban residents was higher. Age, employment status, and the urban-rural identification were the main influential factors of two-week morbidity rate and chronic illness prevalence. After the related factors were controlled, the urban-rural identification was not the impact factor of the health service utilization. CONCLUSION: The urban-rural integration development has promoted the health service accessibility and narrowed the disparity of health to some extent between urban and rural residents. However, the semi-urban residents should be caught a great deal of attention as a special group, and given more employment assistance.

Social health assistance schemes: the case of Medical Financial Assistance for the rural poor in four counties of China.

BACKGROUND: Economic transition which took place in China over the last three decades, has led to a rapid marketization of the health care sector. Today inequity in health and poverty resulting from major illness has become a serious problem in rural areas of China. Medical Financial Assistance (MFA) is a health assistance scheme that helps rural poor people cope with major illness and alleviate their financial burden from major illness, which will definitely play a significant role in the process of rebuilding Chinese new rural health system. It mainly provides assistance to cover medical expenditure for inpatient services or the treatment of major illnesses, with joint funding from the central and local government. The purpose of this paper is to review the design, funding, implementation and to explore the preliminary effects of four counties' MFA in Hubei and Sichuan province of China. METHODS: We used an analytical framework built around the main objective of any social assistance scheme. The framework contains six 'targeting' procedural 'steps' which may explain why a specific group does not receive the assistance it ought to receive. More specifically, we explored to what extent the targeting, a key component of social assistance programs, is successful, based on the qualitative and quantitative data collected from four representative counties in central and western China. RESULTS: In the study sites, the budget of MFA ranged from 0.8 million Yuan to 1.646 million Yuan in each county and the budget per eligible person ranged from 32.67 Yuan to 149.09 Yuan. The preliminary effects of MFA were quite modest because of the scarcity of funds dedicated to the scheme. The coverage rate of MFA ranged from 17.8% to 24.1% among the four counties. MFA in the four counties used several ways to ration a restricted budget and provided only limited assistance. Substantial problems remained in terms of eligibility and identification of the beneficiaries, utilization and management of funds. CONCLUSIONS: MFA needs to be improved further although it evidences the concern of the government for the poor rural people with major illness. Some ideas on how to improve MFA are put forward for future policy making.

Is traditional rural lifestyle a barrier for quality of life assessment? A case study using the Short Form 36 in a rural Chinese population.

PURPOSE: The majority of existing quality of life measures are based on urban-living environments. This study aimed at exploring the validity of using an urban-lifestyle-based health questionnaire with individuals living a traditional rural lifestyle. METHODS: The Short Form-36 (SF-36) interview was administered to 1603 rural Chinese residents. Semantic ambiguity of the items was investigated using tests of internal consistency, test-retest reliability, exploratory factor analysis, and clustering and ordering of item mean scores. The self-explanations from the respondents were adopted to interpret the implications of the changes in meanings of the items. RESULTS: Cronbach's alpha reliability coefficients were high, whereas test-retest reliabilities were low. Consistent with the original factor structure, eight factors were extracted using exploratory factor analysis. However, the composition of these eight factors was not in full accordance with the priori assignment of items to scales. Seven items violated the clustering and ordering of item mean scores. The association between the identified problems in validity and the change in semantic meanings in the context of the rural lifestyle was established. CONCLUSIONS: Quality of life assessment instruments based on urban-living arrangements may not be reliably used with individuals living in rural environments.

[Assessing quality of life in an urban population in Chengdu using the SF-12].

OBJECTIVE: To assess the health-related quality of life in an urban population in Chengdu China using the SF-12. METHODS: A random sampling strategy stratified by age and sex was adopted to select the participants in Chengdu. A total of 1365 respondents with an age of older than 18 years completed the interviewer-administered SF-12 survey. The physical (PCS) and mental (MCS) component summary measures of the SF-12 were calculated using the standard US scoring method and compared to the urban population norms of Hong Kong and Australia. RESULTS: Similar PCS and MCS scores were obtained for the urban Chengdu population compared to the Hong Kong and Australian population norms, albeit a closer similarity between the Chengdu and Hong Kong populations. The PCS and MCS scores of the SF-12 changed with sex and age. CONCLUSION: The age- and sex-adjusted PCS and MCS scores of the SF-12 in the urban Chengdu population can serve as a reference for future studies using the SF-12 in China.

[An eight-year study on maternal and child health service utility in Sichuan province].

OBJECTIVE: To evaluate the effect of intervention on factors influencing the health service utility regarding Maternal and Child Health (MCH) under the 'Qinba Health Project' in Sichuan province. METHODS: 15 towns in 5 programmed counties were selected, using the method of 'random layer sampling' to be the trial group. With similar MCH status and comparable to the trial group, another 9 towns in 3 non-programmed counties were chosen as the control group, using the same sampling method. Indicators on MCH service utility were compared with that in the control group, and the influencing factors of MCH service utility analyzed by logistic model. RESULTS: The main characteristics of the two groups were quite similar at the baseline study, with the average annual family incomes and MCH service per 1000 people. Annual input on MCH services from the government had an distinct increase. The average annual rates of increase regarding the indicators as clean delivery, hospitalized delivery, systematic care on maternal and children, maternal and infant mortality rates were: 1.95%, 9.34%, 4.82%, 3.04%, -2.67%, -13.84% (P < 0.02) through chi2 trend tests. In the trial group, the changes seen in the 6 indicators were better in the control group than in the control group (P < 0.05). Data from the logistic regression model showed that the major influencing factors on the use of hospitalized delivery service were: age of the pregnant woman, average annual income of the family, health insurance status, number of pre-delivery visits, whether on poverty alleviate program, and on knowledge of MCH. CONCLUSION: The intervention project in this programmed area seemed effective and better than the non-programmed area, through an eight-year observation.

[Developing an evaluative indicator system for the institutional development of community health services in Sichuan].

OBJECTIVE: To develop an evaluative index system for the institutional development of community health services in Sichuan. METHODS: An index system was developed through literature review, followed by focus group discussions and Delphi consultation. The weights of the indicators were established by analytical hierarchy process (AHP). RESULTS: The activity coefficients were 100% and 96.43% for the two rounds of expert consultation, respectively. The concordance coefficients were 0.714 and 0.888 for the two rounds of expert consultation, respectively. The Cronbach's alpha were 0.9812 and 0.8873 for the two rounds of expert consultation, respectively. The authority coefficient reached 0.9093. The final indicators comprised 3 primary index, 12 secondary index and 29 tertiary index. CONCLUSION: The expert consultation has achieved reliable results. The established index system can serve as an instrument for the standardized development of community health services institutions.

[Social functions of the longevous elderly population in Dujiangyan].

OBJECTIVE: To describe the social functions of the longevous elderly population in Dujiangyan. METHODS: A questionnaire survey was undertaken in Dujiangyan in 875 elderly people who were over 90 years old. RESULTS: Poor social economic status was prevalent in the longevous elderly population. The elderly people had limited social contacts except from their families. The daily lives of 65. 0% of the longevous elderly were taken care of by their families. More than 81. 8% of the longevous elderly people were financially supported by their families. About 89. 2% of the longevous elderly people had accessed to spiritual supports in difficult circumstances, among 88. 7% came from families. CONCLUSION: Thanks to the family supports, the longevous people in Dujiangyan have maintained good social functions.

[Quantitative assessment of risks for coronary heart diseases in urban residents in Sichuan].

OBJECTIVE: To set a quantitative criteria for determining risk for coronary heart disease (CHD) so that potential risk of an individual dying from CHD can be identified and to lay a foundation for predicting individual risk of CHD. METHODS: Data of case-control and cohort studies published during 1978 to 2002, as well as data of surveillance of behavior exposure in Sichuan province, were collected by retrieval of literatures. Pooled odds ratios (OR) and relative risks (RR) of all risk factors for CHD were estimated using various statistical models with software for meta-analysis, and attributable risk fractions of varied levels of risk factors could be converted. RESULTS: A risk score conversion table (quantitative criteria for assessment) of main risk factors for CHD were developed for men and women aged 15 - 69 at an interval of five years, including smoking, passive smoking, hypertension, high blood cholesterol level, body mass index, lack of physical activity, alcohol drinking, past history of diabetes, and family history of CHD and hypertension. Individuals with all these risk factors had a risk score beyond 1.00, and risk score for those without them was equal to or below 1.00, which would increase with rise in one's risk level. CONCLUSIONS: Estimation of risk of dying from CHD was based on risk score conversion table of risk factors for CHD, which could be used to predict individual potential risk of dying from CHD in the following 10 years. It lays a foundation for health education to persuade people to change their unhealthy lifestyles and behaviors, and could be used in community health services.

[Quantitative assessment of risks on cerebral vascular diseases in urban residents in Sichuan].

OBJECTIVE: To set a quantitative criteria for determining the risks on cerebral vascular disease (CVD) so to identify that potential risk of an individual dying from CVD and to predict the individual risk of CVD. METHODS: Data on case-control and cohort studies published during 1978 to 2003 was collected through retrieval of literatures, and data on surveillance of behavior exposure was provided by Chengdu Municipal Center for Disease Control and Prevention. Pooled odds ratio (OR) and relative risk (RR) of all risk factors for CVD were estimated using software for meta-analysis to enable the varied levels of risk factors be converted into risk fractions by statistical models. RESULTS: A risk score conversion table (quantitative criteria for assessment) of main risk factors for CVD was developed for men and women aged 35 - 69 at an interval of five years, including smoking, passive smoking, hypertension, high blood cholesterol levels, body mass index, lack of physical activity, alcohol drinking, dietary fat consumption, milk intake, oral contraceptive use, past history of diabetes and CVD, family history of CVD etc. Individuals with all these risk factors had a risk score beyond 1.00, but was equal to or below 1.00 when without. The risk score would increase along with the rise of one's risk level. CONCLUSION: Estimation of risk of dying from CVD was based on risk score conversion table of risk factors for CVD, which could be used to predict individual potential risk of dying from CVD in the following 10 years. Our data provides evidence that education to be strengthened to persuade people to change their unhealthy lifestyles and behaviors.