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1.
Chin J Integr Med ; 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31970674

RESUMO

OBJECTIVE: To assess the relationship between yogurt intake and mortality risk from prospective cohort studies. METHODS: The PubMed, EMBASE, and Web of Science databases were searched for all records related to yogurt intake and mortality risk [all-cause or cardiovascular disease (CVD) or cancer mortality] before October 1, 2018. The Newcastle-Ottawa Quality Scale was used to estimate the quality of all eligible articles. The results of the highest and lowest categories of yogurt intake in each study were collected and the effect size was pooled using a random effects model. The dose-response analysis was calculated using the generalized least squares trend estimation model. RESULTS: Eight eligible cohort studies were included in this meta-analysis. There were 235,676 participants in the 8 studies, and the number of deaths was 14,831. Compared with the lowest category, the highest category of yogurt intake was not significantly related with all-cause mortality [hazard ratio (HR)=0.93; 95% confidence interval (CI): 0.85, 1.01], CVD mortality (HR=0.92; 95% CI: 0.81, 1.03) and cancer mortality (HR=0.97; 95% CI: 0.83, 1.12). These studies were homogenous, since the homogeneity test showed that I2 was 28.7%, 15.1% and 11.8%, respectively. However, yogurt intake ⩾200 g/d was significantly associated with a lower all-cause mortality (HR=0.88; 95% CI: 0.80, 0.96) and CVD mortality (HR=0.87; 95% CI: 0.77, 0.99) in the subgroup analysis. The dose-response analysis showed that yogurt intake of 200 g/d was inversely associated with all-cause mortality (P=0.041, HR=0.95, 95% CI: 0.92, 1.00) and CVD mortality (P=0.009, HR=0.92, 95% CI: 0.86, 0.98), and all of which were linear relationship (P>0.05). CONCLUSIONS: This review provided the evidence regarding yogurt intake can reduce all-cause and CVD mortality. Although some positive findings were identified, more high-quality cohort studies and randomized controlled trials are warranted on a possible protective effect of yoghurt on health.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31909850

RESUMO

OBJECTIVES: To examine whether moral hazard may exist under unsupervised home-based online applications, leading to more assistive technology devices (ATDs) and larger per capita expenditures on ATDs than under supervised community center-based online applications. METHODS: Using the data from the Assistive Devices Resource Centre in Shanghai, descriptive statistics were estimated for the sociodemographics of applicants. Multiple linear regression and logistic regression were used to test the effect of the introduction of home-based online applications. RESULTS: In 2015-2016, there were marked increases of 22.3% in the total number of ATDs and 27.2% in the total expenditure on ATDs compared with 2013-2014. The per capita number and expenditure also demonstrated an increasing trend. More devices were applied for in 2015-2016 than in 2013-2014, yielding a higher expenditure per capita (P < .001). Interestingly, with an invisible price, more devices were applied for at home than in community centers (P < .001), but the expenditure per capita was smaller (P < .001). CONCLUSIONS: The introduction of online applications increased the number of ATDs per capita. The home-based applications induced the purchase of more ATDs but not higher expenditures on ATDs. Individuals with disabilities tend to request the maximum number of ATDs allowed by the application rules, which is an indicator of moral hazard. The prices of ATDs were not visible for individuals with disabilities, which may cause individuals to order costlier ATDs when applying at home. Stricter review may be needed to reign in the potential moral hazard among online applicants with disabilities.

3.
Int J Equity Health ; 18(1): 179, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752854

RESUMO

BACKGROUND: The public health workforce (PHW) is a key component of a country's public health system. Since the outbreak of SARS (severe acute respiratory syndrome) in 2003, the scale of PHW in China has been continuously expanding, but policymakers and researchers still focus on the distribution of public health personnel, especially the regional inequality in such distribution. We aimed to identify the root cause of PHW inequality by decomposing different geographical units in China. METHODS: This study was based on data from a nationwide survey, which included 2712 county-level data. The distribution of the PHW in geographical units was evaluated by the Gini coefficient and Theil T index, and inequalities at regional, provincial, and municipal levels were decomposed to identify the root causes of inequalities in the PHW. Additionally, the contextual factors affecting the distribution of the PHW were determined through regression analysis. RESULTS: The overall inequality results show that health professional and field epidemiological investigators faced worse inequality than the staff. In particular, field epidemiological investigators had a Gini coefficient close to 0.4. Step decomposition showed that within-region inequalities accounted for 98.5% or more of overall inter-county inequality in the distribution of all PHW categories; provincial decomposition showed that at least 74% of inequality is still distributed within provinces; the overall contribution of within-municipal inequality and between-municipal inequality was basically the same. Further, the contextual factor that influenced between-municipality and within-municipality inequality for all three categories of PHWs was the agency building area per employee. Per capita GDP had a similar effect, except for between-municipality inequality of professionals and within-municipality inequality of field epidemiological investigators. CONCLUSIONS: The successive decomposition showed that inequality is mainly concentrated in counties at the within-province and within-municipal levels. This study clearly suggests that the government, especially the municipal government at the provincial level, should increase financial investment in Centers for Disease Control and Prevention (CDCs) with worse resource allocation in their jurisdiction through various ways of compensation and incentives, enhance their infrastructure, and improve the salary of personnel in these institutions, to attract more public health professionals to these institutions.

4.
J Biomed Opt ; 24(11): 1-4, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31705637

RESUMO

Lymph node biopsy is a primary means of staging breast cancer, yet standard pathological techniques are time-consuming and typically sample less than 1% of the total node volume. A low-cost fluorescence optical projection tomography (OPT) protocol is demonstrated for rapid imaging of whole lymph nodes in three dimensions. The relatively low scattering properties of lymph node tissue can be leveraged to significantly improve spatial resolution of lymph node OPT by employing angular restriction of photon detection. It is demonstrated through porcine lymph node metastases models that simple filtered-backprojection reconstruction is sufficient to detect and localize 200-µm-diameter metastases (the smallest clinically significant) in 1-cm-diameter lymph nodes.

5.
Contrast Media Mol Imaging ; 2019: 7561862, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30718985

RESUMO

Purpose: Paired-agent molecular imaging methods, which employ coadministration of an untargeted, "control" imaging agent with a targeted agent to correct for nonspecific uptake, have been demonstrated to detect 200 cancer cells in a mouse model of metastatic breast cancer. This study demonstrates that indocyanine green (ICG), which is approved for human use, is an ideal control agent for future paired-agent studies to facilitate eventual clinical translation. Methods: The kinetics of ICG were compared with a known ideal control imaging agent, IRDye-700DX-labeled antibody in both healthy and metastatic rat popliteal lymph nodes after coadministration, intradermally in the footpad. Results: The kinetics of ICG and antibody-based imaging agent in tumor-free rat lymph nodes demonstrated a strong correlation with each other (r = 0.98, p < 0.001) with a measured binding potential of -0.102 ± 0.03 at 20 min postagent injection, while the kinetics of ICG and targeted imaging agent shows significant separation in the metastatic lymph nodes. Conclusion: This study indicated a potential for microscopic sensitivity to cancer spread in sentinel lymph nodes using ICG as a control agent for antibody-based molecular imaging assays.


Assuntos
Verde de Indocianina/química , Linfonodos/diagnóstico por imagem , Imagem Óptica/métodos , Linfonodo Sentinela/diagnóstico por imagem , Animais , Feminino , Cinética , Camundongos , Ratos
6.
Sci Total Environ ; 664: 116-126, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-30739846

RESUMO

Ferrous dosing is used to reduce phosphorus concentration and alleviate polymeric membrane fouling in membrane bioreactor (MBR). However, limited studies have been conducted to investigate the impacts of ferrous dosing on ceramic membrane fouling, nutrient removal efficiency and microbial community. Accordingly, the aim of this study was to investigate the effect of intermittent ferrous dosing with Fe/P molar ratios of 2 and 1 (with a dosing frequency of every two days) on the overall nutrient removal, functional microbial changes and membrane fouling in ceramic membrane bioreactors (CMBR) in treatment of wastewater. TP concentration of 10 mg/L in influent decreased to 1.94 ±â€¯0.62 mg/L (control), 0.38 ±â€¯0.22 mg/L (Fe/P = 1) and 0.31 ±â€¯0.18 mg/L (Fe/P = 2) in the effluent, respectively. Meanwhile, the effluent total nitrogen (TN) concentrations with Fe/P = 1 treatment (6.80 ±â€¯2.02 mg/L) and Fe/P = 2 treatment (5.12 ±â€¯2.28 mg/L) were lower than that of the control (7.72 ±â€¯2.36 mg/L). Compared to Fe/P = 1, the TN removal performance was better for Fe/P = 2 mainly due to the increased abundance of denitrifying bacteria (Zoogloea and Acinetobacter). In addition, excess iron dose might have toxic effects on bacterial physiology, however the Fe concentrations that cause cell damage vary for different bacteria. The relative abundance of Zoogloea (aerobic denitrifying bacteria) continuously increased with ferrous addition (Fe/P = 2), while other bacteria including Dechloromonas, Hyphomicrobium and Thauera (anoxic denitrifying bacteria), Nitrospira (nitrifying bacteria) and Candidatus Accumulibacter (phosphorus accumulating organism) decreased sharply. Furthermore, membrane fouling was effectively moderated by ferrous dosing and Fe/P = 1 treatment showed improved membrane fouling mitigation than Fe/P = 2. Overall, intermittent ferrous addition in CMBR with Fe/P molar ratio of 1 was beneficial to the removal of nutrients (TP, TN and organics), enhanced succession of microbial community and membrane fouling mitigation.


Assuntos
Reatores Biológicos , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/química , Cerâmica , Desnitrificação , Compostos Ferrosos , Membranas Artificiais , Microbiota , Fósforo
7.
J Public Health (Oxf) ; 41(1): 158-163, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29385505

RESUMO

BACKGROUND: To evaluate the impact of the routine hepatitis B vaccination program of infants in China. METHODS: The incidence of new hepatitis B infection and coverage with three doses of the vaccines by age groups and provinces were derived from the National Network Direct Report System of Infectious Disease during 2004-10. Chi square test and Pearson correlation analysis were used to analyze differences in incidence according to vaccination coverage and the relationship between the coverage with three doses and the incidence in different provinces. RESULTS: The incidence of new infection was 8.96/100 000 among children with complete coverage (0-15 years old), which was significantly lower than that with partial or no coverage. Among 0-9-year-old children in 2010, the incidence of new infection was 6.36/100 000, which was significantly lower than 2004. Considering the impact of vaccination on cumulative incidence among 0-5-year-old children, a 2.2-fold greater incidence of new infection was observed in provinces with the lowest to the highest vaccination rate. CONCLUSION: The impact of the routine hepatitis B vaccination program of infants in China has become more apparent over time. Program implementation and regional disequilibrium should be payed attention to as well as the expanded program.

8.
J Surg Oncol ; 118(2): 301-314, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30196532

RESUMO

Identification of cancer spread to tumor-draining lymph nodes offers critical information for guiding treatment in many cancer types. Current clinical methods of nodal staging are invasive and can have substantial negative side effects. Molecular imaging protocols have long been proposed as a less invasive means of nodal staging, having the potential to enable highly sensitive and specific evaluations. This review article summarizes the current status and future perspectives for molecular targeted nodal staging.


Assuntos
Linfonodos/diagnóstico por imagem , Imagem Molecular/métodos , Neoplasias/diagnóstico por imagem , Animais , Humanos , Linfonodos/patologia , Estadiamento de Neoplasias , Neoplasias/patologia , Biópsia de Linfonodo Sentinela/métodos
9.
Biomacromolecules ; 19(11): 4168-4181, 2018 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-30253093

RESUMO

Biomaterial strategies focused on designing scaffolds with physiologically relevant gradients provide a promising means for elucidating 3D vascular cell responses to spatial and temporal variations in matrix properties. In this study, we present a photopolymerization approach, ascending photofrontal free-radical polymerization, to generate proteolytically degradable hydrogel scaffolds of poly(ethylene) glycol with tunable continuous gradients of (1) elastic modulus (slope of 80 Pa/mm) and uniform immobilized RGD concentration (2.06 ± 0.12 mM) and (2) immobilized concentration of the RGD cell-adhesion peptide ligand (slope of 58.8 µM/mm) and uniform elastic modulus (597 ± 22 Pa). Using a coculture model of vascular sprouting, scaffolds embedded with gradients of elastic modulus induced increases in the number of vascular sprouts in the opposing gradient direction, whereas RGD gradient scaffolds promoted increases in the length of vascular sprouts toward the gradient. Furthermore, increases in vascular sprout length were found to be prominent in regions containing higher immobilized RGD concentration.


Assuntos
Materiais Biocompatíveis/química , Adesão Celular , Hidrogéis/química , Neovascularização Fisiológica , Oligopeptídeos/química , Peptídeo Hidrolases/metabolismo , Materiais Biocompatíveis/metabolismo , Módulo de Elasticidade , Matriz Extracelular , Células Endoteliais da Veia Umbilical Humana , Humanos , Hidrogéis/metabolismo , Teste de Materiais , Oligopeptídeos/metabolismo , Polietilenoglicóis , Engenharia Tecidual
10.
BMC Public Health ; 18(1): 474, 2018 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-29642902

RESUMO

BACKGROUND: Public health emergencies have challenged the public health emergency management systems (PHEMSs) of many countries critically and frequently since this century. As the world's most populated country and the second biggest economy in the world, China used to have a fragile PHEMS; however, the government took forceful actions to build PHEMS after the 2003 SARS outbreak. After more than one decade's efforts, we tried to assess the improvements and problems of China's PHEMS between 2002 and 2012. METHODS: We conducted two rounds of national surveys and collected the data of the year 2002 and 2012, including all 32 provincial, 139 municipal, and 489 county CDCs. The municipal and county CDCs were selected by systematic random sampling. Twenty-one indicators of four stages (preparation, readiness, response and recovery) from the National Assessment Criteria for CDC Performance were chosen to assess the ten-year trends. RESULTS: At the preparation stage, organization, mechanisms, workforce, and stockpile across all levels and regions were significantly improved after one decade's efforts. At the readiness stage, the capability for formulating an emergency plan was also significantly improved during the same period. At the response stage, internet-based direct reporting was 98.8%, and coping scores were nearly full points of ten in 2012. At the recovery stage, the capabilities were generally lower than expected. CONCLUSIONS: Due to forceful leadership, sounder regulations, and intensive resources, China's PHEMS has been improved at the preparation, readiness, and response stages; however, the recovery stage was still weak and could not meet the requirements of crisis management and preventive governance. In addition, CDCs in the Western region and counties lagged behind in performance on most indicators. Future priorities should include developing the recovery stage, establishing a closed feedback loop, and strengthening the capabilities of CDCs in Western region and counties.


Assuntos
Surtos de Doenças/prevenção & controle , Emergências , Administração em Saúde Pública/tendências , Saúde Pública , China/epidemiologia , Humanos
11.
Am J Public Health ; 106(12): 2093-2102, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27831781

RESUMO

OBJECTIVES: To assess the improvements of the Chinese Centers for Disease Control and Prevention (CDCs) system between 2002 and 2012, and problems the system has encountered. METHODS: We obtained data from 2 national cross-sectional surveys in 2006 and 2013, including 32 provincial, 139 municipal, and 489 county-level CDCs throughout China. We performed a pre-post comparative analysis to determine trends in resource allocation and service delivery. RESULTS: The overall completeness of public health services significantly increased from 47.4% to 76.6%. Furthermore, the proportion of CDC staff with bachelor's or higher degrees increased from 14.6% to 32.6%, and governmental funding per CDC increased 5.3-fold (1.283-8.098 million yuan). The working area per CDC staff increased from 37.9 square meters to 63.3 square meters, and configuration rate of type A devices increased from 28.1% to 65.0%. Remaining problems included an 11.9% reduction in staff and the fact that financial investments covered only 71.1% of actual expenditures. CONCLUSIONS: China's CDC system has progressed remarkably, enabling quicker responses to emergent epidemics. Future challenges include establishing a sustainable financing mechanism and retaining a well-educated, adequately sized public health workforce.


Assuntos
Controle de Doenças Transmissíveis/tendências , Órgãos Governamentais , Medicina Preventiva/tendências , China , Estudos Transversais , Órgãos Governamentais/organização & administração , Humanos , Alocação de Recursos/organização & administração , Inquéritos e Questionários
12.
BMC Health Serv Res ; 16(1): 422, 2016 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-27549793

RESUMO

BACKGROUD: This study aimed to measure the poverty head count ratio and poverty gap of rural Yanbian in order to examine whether China's New Rural Cooperative Medical Scheme has alleviated its medical impoverishment and to compare the results of this alternative approach with those of a World Bank approach. METHODS: This cross-sectional study was based on a stratified random sample survey of 1,987 households and 6,135 individuals conducted in 2008 across eight counties in Yanbian Korean Autonomous Prefecture, Jilin province, China. A new approach was developed to define and identify medical impoverishment. The poverty head count ratio, relative poverty gap, and average poverty gap were used to measure medical impoverishment. Changes in medical impoverishment after the reimbursement under the New Rural Cooperative Medical Scheme were also examined. RESULTS: The government-run New Rural Cooperative Medical Scheme reduced the number of medically impoverished households by 24.6 %, as well as the relative and average gaps by 37.3 % and 38.9 %, respectively. CONCLUSIONS: China's New Rural Cooperative Medical Scheme has certain positive but limited effects on alleviating medical impoverishment in rural Yanbian regardless of how medical impoverishment is defined and measured. More governmental and private-sector efforts should therefore be encouraged to further improve the system in terms of financing, operation, and reimbursement policy.


Assuntos
Política de Saúde/economia , Pobreza , Serviços de Saúde Rural/economia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Estudos Transversais , Feminino , Apoio Financeiro , Pesquisas sobre Serviços de Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Serviços de Saúde Rural/organização & administração , Serviços de Saúde Rural/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adulto Jovem
13.
Trop Med Int Health ; 21(9): 1106-14, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27404084

RESUMO

OBJECTIVES: The Chinese government has greatly increased funding for disease control and prevention since the 2003 Severe Acute Respiration Syndrome crisis, but it is also concerned whether these increased resources have been used efficiently to improve public health services. We aimed to assess the efficiency of county-level Centers for Disease Control and Prevention (CDCs) of China and to identify strategies for optimising their performance. METHODS: A total of 446 county-level CDCs were selected based on systematic sampling throughout China. The data envelopment analysis framework was used to calculate the efficiency score of sampled CDCs in 2010. The Charnes, Cooper and Rhodes (CCR) model was applied to calculate the overall and scale efficiency, and the Banker, Charnes and Cooper (BCC) model was used to assess technical efficiency. Models included three inputs and seven outputs. A projection analysis was conducted to identify the difference between projection value and actual value for inputs and outputs. RESULTS: The average overall efficiency score of CDCs was 0.317, and the average technical efficiency score was 0.442 and 88.3% with decreasing returns to scale. Projection analysis indicated that all seven categories of outputs were underproduced. CDCs in the eastern region tended to perform better than CDCs in the middle and the western region. CONCLUSIONS: Most county-level CDCs in China were operated inefficiently. Emphasis should be put on increasing staff and general operating expenses through current governmental funding, upgrading healthcare providers' competencies and enhancing the standardisation of operational management, so that CDCs could utilise their resources more efficiently.


Assuntos
Eficiência , Órgãos Governamentais/normas , Serviços de Saúde/normas , Saúde Pública/normas , China , Humanos , Inquéritos e Questionários
14.
BMC Public Health ; 15: 1079, 2015 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-26494015

RESUMO

BACKGROUND: Although much public scrutiny and academic attention has focused on the evaluations of system implementation since the beginning of New Rural Cooperative Medical System (NRCMS) in China, few studies have systematically evaluated the achievements of the stated policy goals. The purpose of this study is to examine to what extent the policy goals of NRCMS have been achieved. METHODS: Using multistage sampling processes, two rounds of cross-sectional household surveys including 9787 and 7921 rural households were conducted in Eastern China in year 2000 and year 2008, respectively. A pre- and post-implementation comparison was used to evaluate the achievement of policy goals in three measures: impoverishment from major health hazards, household financial risk from medical expenses, and rural income inequity. Intention surveys were also applied to find out potential obstacles in the implementation of NRCMS. RESULTS: The rate of re-impoverishment from health hazard was reduced from 2.69 % ex ante to 2.12 % ex post, a decrease of 21.13 %. The severity of impoverishment fell from a previous 4.66 % to 3.02 %, a decline of 35.18 %. Economic risk of medical treatment population relative to the whole population fell from 2.62 ex ante to 2.03 ex post, a 22.52 % reduction. As indication of effect on improving income equity, the Gini coefficient fell from 0.4629 to 0.4541. The effects of NRCMS were significantly better than those of RCMS. Despite the preliminary achievements, our intention survey of key respondents identified that technical difficulties in actuarial funding and more sustainable reimbursement schedules has become the most challenging barriers in achieving the goals of NRCMS, while raising the insurance premium on NRCMS was no longer as big a barrier. CONCLUSIONS: With NRCMS, China has established a medical security system to reduce the financial burden of healthcare on rural residents. NRCMS has achieved some positive though limited effects; but technical difficulties in the implementation of NRCMS have become barriers to achieve the pre-set policy goals. Efforts should be made to improve the capacity building in the design of the reimbursement schemes for the implementers of NRCMS, such as identifying medical impoverishment, calculating actuarial funding levels for the risk pooling.


Assuntos
Assistência à Saúde/organização & administração , Política de Saúde/economia , Serviços de Saúde Rural/organização & administração , População Rural/estatística & dados numéricos , Logro , Adulto , China/epidemiologia , Estudos Transversais , Assistência à Saúde/economia , Feminino , Apoio Financeiro , Organização do Financiamento/estatística & dados numéricos , Metas , Humanos , Masculino , Programas Nacionais de Saúde/organização & administração , Serviços de Saúde Rural/economia
15.
Int J Health Plann Manage ; 30(1): E42-55, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24986628

RESUMO

As the most important public health service providers in rural China, village doctors are facing a new challenge of heavier workload resulting from the recent policy of public health service equalization. Studies on the shortage of village doctors, mainly based on the national statistics, have so far been very broad. This study conducted detailed field surveys to identify specific factors of and potential solutions to the shortage in village doctors. Eight hundred forty-four village doctors and 995 health decision makers and providers were surveyed through a questionnaire, and some of them were surveyed by in-depth face-to-face interviews and focus group interviews. Opinions on the shortage in village doctors and the potentially effective approaches to addressing the problem were sought. Some village doctors (51.3%) were at least 50 years old. Some village doctors (92.3%) did not want their children to become a village doctor, and the main reasons were "low salary" and "lack of social security". Village doctors felt that it was difficult to provide all the required public health services. Local residents indicated that they established good relationships with village doctors. Some health decision makers and providers (74.0%) thought that they needed more village doctors. The shortage in village doctors presents a major obstacle toward the realization of China's policy of public health service equalization. The aging of current village doctors exacerbates the problem. Policies and programs are needed to retain the current and attract new village doctors into the workforce. Separate measures are also needed to address disparities in socioeconomic circumstance from village to village.


Assuntos
Política de Saúde , Área Carente de Assistência Médica , Médicos/provisão & distribução , Prática de Saúde Pública , Serviços de Saúde Rural , Adulto , Idoso , China , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Administração em Saúde Pública , Serviços de Saúde Rural/organização & administração , Inquéritos e Questionários , Recursos Humanos
16.
BMC Public Health ; 14: 1193, 2014 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-25413667

RESUMO

BACKGROUND: In the 12th Five-Year Plan, the Chinese government set the goal of increasing life expectancy by one year. The purpose of this study is to examine the impact of major causes of death on the life expectancy of the Chinese people between 1950 and 2010 and predict changing trends to identify major issues requiring future attention. METHODS: A continuous database organised by population and death data on diseases by age group between 1950 and 2010 were created from A Province in Eastern China. The diseases were classified into four categories by the International Classification of Diseases-10 (ICD-10): infectious and parasitic diseases, chronic diseases, accidental injuries, and maternal diseases. Potential gains in life expectancy (PGLEs) were applied to reflect the impact on life expectancy caused by deaths from various diseases, by using the cause-eliminated life table. RESULTS: The PGLEs of infectious and parasitic diseases decreased from 15.59 years in 1950, to 0.07 year in 2010, and have remained low since 2000. However, the PGLEs of chronic diseases increased from 8.70 years in 1950, to 13.36 years in 2010, and indicated an increasing future trend. The two opposite trends exhibited a 'scissors-like difference'. The proportion of accidental injuries and maternal diseases in the death spectrum was low. The PGLEs of accidental injuries decreased from 2.95 years in 1950, to 0.86 year in 2010, maintaining a low level, while the PGLEs of maternal diseases dropped from 0.56 to 0.002 year during the same period, approaching zero. CONCLUSIONS: The findings of this study provide useful information, which could contribute to a more effective allocation of public health programmes. In recent years, chronic diseases and accidental injuries have emerged as major factors influencing life expectancy. Primary and secondary prevention actions, such as public education, modification of behaviours, and introduction of safety measures should be emphasised in efforts to promote life expectancy. The morbidity and mortality rates of infectious, parasitic, and maternal diseases should be maintained at low levels.


Assuntos
Causas de Morte , Expectativa de Vida/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Doenças Transmissíveis/mortalidade , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Mortalidade Materna/tendências , Pessoa de Meia-Idade , Gravidez , Ferimentos e Lesões/mortalidade
17.
J Aging Health ; 26(7): 1155-71, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25239971

RESUMO

OBJECTIVE: This study aimed to examine the prevalence of depressive symptoms among U.S. Chinese older adults. METHOD: Data were from the Population Study of Chinese Elderly in Chicago (PINE) study, a population-based survey of U.S. Chinese older adults aged 60 years and above. The Patient Health Questionnaire (PHQ-9) was used to examine depressive symptoms. RESULTS: Of the 3,159 community-dwelling Chinese older adults, 1,717 (54.4%) reported having any depressive symptoms in the last 2 weeks. Older age (r = .09), being female (r = .10), lower income (r = .09), not being married (r = .07), having fewer years in the United States (r = .05), lower overall health status (r = .32), poorer quality of life (r = .14), and worsening health over the past year (r = .24) were significantly and positively correlated with any depressive symptoms. DISCUSSION: Depressive symptoms are common among U.S. Chinese older adults in the Greater Chicago area. Further longitudinal studies should be conducted to better understand risk factors and outcomes of depressive symptoms among U.S. Chinese older adults.


Assuntos
Americanos Asiáticos/psicologia , Depressão/etnologia , Características de Residência/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Americanos Asiáticos/estatística & dados numéricos , Chicago/epidemiologia , China/etnologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
18.
Pak J Med Sci ; 30(3): 659-63, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24948999

RESUMO

OBJECTIVES: This article aims to introduce, compare and analyze the design and development of Critical Illness Insurance systems in different parts of China under different social and economic conditions, to explain their characteristics and similarities. It may provide references to other countries, especially developing countries, to solve the problem of high medical costs. METHODS: According to the methods in Comparative Economics, 3 areas (Taicang in Jiangsu, Zhanjiang in Guangdong, Xunyi in Shanxi) which are in high, medium and low socio-economic condition respectively were chosen in China. Their critical illness insurance systems were analyzed in the study. RESULTS: Each system shares several common points, including coordinating urban and rural medical insurance fund, financing from the basic medical insurance surplus, and exploring payment reform and so on. But in the way of management, Taicang and Zhanjiang cooperate with commercial insurance agencies, but Xunyi chooses autonomous management by government. In Xunyi, multi-channel financing is relatively more dispersed, while funds of Taicang and Zhanjiang are mainly from the basic medical insurance surplus. The specific method of payment is different among these three areas. CONCLUSION: Because of the differences in economic development, population structure, and sources of funds, each area took their own mode on health policy orientation, financing, payment, coverage, and fund management to design their Critical Illness Insurance systems. This might provide references to other areas in China and other developing countries in the world.

19.
BMC Public Health ; 14: 158, 2014 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-24520921

RESUMO

BACKGROUND: Today's rapid growth of migrant populations has been a major contributor to the human immunodeficiency virus (HIV) epidemic. However, relatively few studies have focused on HIV/acquired immunodeficiency syndrome (AIDS)-related knowledge, attitudes, and practice among rural-to-urban migrants in China. This cross-sectional study was to assess HIV/AIDS-related knowledge and perceptions, including knowledge about reducing high-risk sex. METHODS: Two-phase stratified cluster sampling was applied and 2,753 rural migrants participated in this study. An anonymous self-administered questionnaire was conducted in Guangdong and Sichuan provinces in 2007. Descriptive analysis was used to present the essential characteristics of the respondents. Chi-square test and multiple logistic regression models were performed to examine the associations between identified demographic factors and high-risk sex, sexually transmitted disease (STD) symptoms, and access to HIV screening services among the seven types of workers. RESULTS: 58.6% of participants were knowledgeable about HIV/AIDS transmission, but approximately 90% had a negative attitude towards the AIDS patients, and that 6.2% had engaged in high-risk sex in the past 12 months. Logistic regression analysis revealed sex, marital status, income, migration and work experience to be associated with high-risk sex. Among the 13.9% of workers who reported having STD symptoms, risk factors that were identified included female gender, high monthly income, being married, daily laborer or entertainment worker, frequent migration, and length of work experience. Only 3% of migrant workers received voluntary free HIV screening, which was positively associated with monthly income and workplace. CONCLUSIONS: HIV/AIDS knowledge, attitudes, and practices among rural migrants in China remain a thorny health issue, and use of healthcare services needs to be improved. Low levels of education and knowledge regarding HIV/AIDS among housekeepers and migrant day laborers result in this population likely being engaged in high-risk sex. Government programs should pay more attention to public education, health promotion and intervention for the control of the HIV/AIDS epidemic in China.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde/estatística & dados numéricos , Migrantes , Sexo sem Proteção , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , Inquéritos e Questionários , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
20.
BMC Health Serv Res ; 13: 506, 2013 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-24308317

RESUMO

BACKGROUND: Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China. METHODS: Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants. RESULTS: The incidence of household catastrophic medical expenses in eastern China ranged from 9.24% to 24.79%. Incidence of household catastrophic medical expenses was lower if the head of household had a higher level of education, labor insurance coverage, while the incidence was higher if they lived in rural areas, had a family member with chronic diseases, had a child younger than 5 years old, had a person at home who was at least 65 years old, and had a household member who was hospitalized. Moreover, the impact of the economic level on catastrophic medical expenses was non-linear. The poorest group had a lower incidence than that of the second lowest income group and the group with the highest income had a higher incidence than that of the second highest income group. In addition, region was a significant determinant. CONCLUSIONS: Reducing the incidence of household catastrophic medical expenses should be one of the priorities of health policy. It can be achieved by improving residents' health status to reduce avoidable health services such as hospitalization. It is also important to design more targeted health insurance in order to increase financial support for such vulnerable groups as the poor, chronically ill, children, and senior populations.


Assuntos
Doença Catastrófica/economia , Gastos em Saúde/estatística & dados numéricos , Política de Saúde , Doença Catastrófica/epidemiologia , China/epidemiologia , Estudos Transversais , Assistência à Saúde/economia , Assistência à Saúde/estatística & dados numéricos , Características da Família , Financiamento Pessoal/economia , Financiamento Pessoal/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Renda/estatística & dados numéricos , Inquéritos e Questionários
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