中国老年人临终地点及影响因素研究

文章基于2008年、2011年、2014年北京大学中国老年人健康长寿影响因素追踪调查的死亡数据对中国老年人临终地点、影响因素及变化趋势进行研究。居住在城镇、年龄较小、社会经济地位高、拥有医疗保险、患有慢性疾病的老年人更可能"临终于医院";临终照护者为配偶、生活不能自理的老年人更可能"临终在家"。从变化趋势看,中国老年人"临终于医院"的比例有所上升,但仍以"临终在家"为主。研究认为其主要原因为80岁及以上高龄老年人占老年人口比例上升,城镇化发展背景下中国大多数老年人依然生活在农村,基层医疗卫生机构(如村卫生室)的发展增强了其临终医疗服务能力。在亲人的关心和注视下离开,在自己的家中接受临终关怀是多数老年人的临终心愿,也是临终的最佳选择。基于此,文章建议在中国老年人临终地点仍以"临终在家"为主的背景下,政府应出台相关政策,进一步增强基层医疗卫生机构的临终医疗服务能力,支持"家庭照护+上门医疗服务"的居家临终照护模式,这不仅能够满足多数老年人"临终在家"的意愿,减轻临终老年人的家庭经济负担,也可以在一定程度上缓解"临终于医院"所带来的医院床位资源紧缺。     

甘南藏族自治州男性人口生命表和死亡分析

本文用Brass曾生子女存活比估算儿童死亡率的方法和Gompertz死亡率定律等方法对甘南藏族自治州的“五普”男性人口的死亡和生存原始数据作了进一步的修匀和校正。在此基础上。我们用Farlle死亡概率法编制出了甘南藏族自治州男性人口的简略生命表．并通过生命表的结果分析了甘南州男性人口的死亡水平、死亡模式和死亡的性别格局。     

高度老龄化地区养老服务探索及发展策略研究--以天津市为例

人口老龄化加剧、社会经济发展转型与政府职能转变成为大力推动养老服务发展的客观要求。天津市已成为我国高度老龄化地区之一,在政府主导下初步形成了以社区居家养老和机构养老为主干的养老服务体系。但养老服务建设缺乏详细规划且管理机制尚未健全、养老服务事业的经费投入难以满足现实需求、区域间的养老服务资源非均等性明显、民办养老机构发展困难、专业养老护理人员缺乏等问题逐渐显现。未来时期应完善制度顶层设计和明确政府养老服务财政责任、促进养老服务管理标准化和加强行业监管、构建公办与民办养老机构差异化发展格局、促进养老服务人员的多元化与专业化、探索建立老年护理保险制度,从而推动养老服务健康发展。     

中国1982年后人口普查和抽样调查中死亡漏报的估计——基于Bayesian分层回归模型

利用Bayesian分层回归模型估计中国1982年后历次人口普查和抽样调查的死亡漏报率及其随时间的变化。结果表明:0岁死亡漏报率随时间的变化具有明显的阶段性,而1～4岁死亡漏报率随时间的变化趋势不明显;全年龄、5～14岁和15～59岁、60～89岁和90岁及以上死亡漏报率随时间的变化基本近似且同样具有阶段性。受漏报原因和不同时期社会背景的影响,女性1～4岁的死亡漏报率不一定低于0岁的死亡漏报率。人口普查成人阶段各年龄死亡漏报率差别较大,而人口抽样调查则较为一致。2000年人口普查男性和2010年全人口90岁及以上死亡率偏低是由比较严重的死亡漏报造成。死亡漏报对预期寿命计算误差的影响因年龄而异,二者关系在婴幼儿中较弱,其余年龄死亡漏报和预期寿命误差存在显著线性正相关。     

Diabetes mellitus in Native Americans: The problem and its implications

Since World War II, diabetes has become one of the most common serious diseases among Native Americans. Rates of diabetes and its complications, which include premature death, renal failure, and limb amputation, are substantially higher among Native Americans than among the US general population, and the frequency of diabetes among Native Americans is increasing. Several potentially modifiable factors, including obesity, dietary composition, and physical inactivity, are thought to be contributing to these high rates. The potential benefit from prevention of diabetes is considerable, and a population-based approach may be the most effective way of achieving sustainable lifestyle changes among Native Americans. Estimation of the social and economic costs of diabetes and assessment of the marginal costs and benefits of various diabetes control measures can support resource allocation decisions aimed at improving the health of Native American people.     

Aging of Indian Women in India: The Experience of Older Women in Formal Care Homes

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for ‘pay and stay homes’, an emerging type of old age home in India. Majority of the 97 women residents of ‘pay and stay’ homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.     

Two Centuries of Mortality Change in Central Japan: The Evidence From a Temple Death Register

Temple registers in a remote area of central Japan are used to produce a portrait of mortality change over a period of nearly two centuries. This portrait is most remarkable in showing a near-stability in life expectancy at birth between 30 and 40 years until the middle of the twentieth century. This stability was to some extent a product of offsetting trends. Infant and child mortality declined sharply after 1885, coinciding with a major national effort to vaccinate against smallpox. At the same time, mortality was rising at ages 15–29 as industrialization brought increased exposure to tuberculosis. Both these trends are likely to have been shared throughout much of rural Japan.     

How Belief in a Just World Benefits Mental Health: The Effects of Optimism and Gratitude

Past research suggests that individuals’ belief in a just world (BJW) is closely connected with their mental health. To clarify the underlying mechanism, the current study proposes that BJW encourages optimism and gratitude which then mediates the relationship between BJW and mental health as indicated by subjective well-being (SWB) and depression. A sample of 1,200 undergraduates yields results indicating that (a) BJW influences optimism, gratitude, SWB, and depression after controlling for gender, age, income, and personality; (b) optimism and gratitude mediate BJW effects by increasing SWB and decreasing depression. The issues of BJW’s adaptive functions are discussed.     

Returns on education amongst men in England and Wales: The impact of residential segregation and ethno-religious background

Individuals’ occupational and educational attainment is influenced by their ethnicity, religion and colour in the UK and elsewhere. In this paper, we analyse the impact of ethnicity, religion and colour along with residential segregation¹ and socio-economic deprivation on returns to education for men in England and Wales. We analyse the 2001 UK census data by employing multi-level logistic regression models. It is found that non-White groups including Christian Black-African, UK born Sikh-Indians and South Asian Muslims are found to suffer an ethnic penalty compared to Christian White-British. While there is evidence to suggest that Muslim men may experience a greater penalty compared to some non-Whites other non-Muslim groups too face ethno-religious penalties, sometimes even more severely such as in the case of Christian Black-Africans. Socio-economic difficulties faced by ethnic minorities are also linked to spatial segregation only when associated with high levels of area deprivation. This suggests that what matters may not be segregation per se, but whether or not it is associated with deprivation.     

Measuring the extent, depth, and severity of food insecurity: an application to American Indians in the USA

Within the extensive food insecurity literature, little work has been done regarding (a) the depth and severity of food insecurity and (b) the food insecurity of American Indians. This paper addresses both these topics with data from the 2001 to 2004 Core Food Security Module of the Current Population Survey. To measure food insecurity, three axiomatically derived measures of food insecurity are used. As expected, given the worse economic conditions facing American Indians, their food insecurity levels are generally higher than non-American Indians. However, the magnitude and significance of these differences differ depending on the choice of food insecurity measure.

性产业中老年客人群体艾滋病风险及性网络状况——基于广西某边境县的实证分析

近年来,我国艾滋病疫情发展显示,50岁以上年龄男性报告病例数增加明显,且以性途径传播为主。研究采取定性和定量结合方法,深入广西某边境县当地低交易价格性服务场所进行观察和访谈,并针对40名小姐,108名客人发放问卷、进行梅毒、艾滋病病毒抗体检测。对当地性网络的研究发现,当地低交易价格性产业已经形成较为稳定的性网络。小姐在其间有着较高的邻连度,而部分活跃的客人表现出更大的桥梁作用。同时,网络成员之间保持了相当长期的交往,网络成员之间的"熟悉"成为采取安全性行为的消解因素。诸多因素构成了通过该网络将老年人群暴露于艾滋病风险的可能性。     

Cardiovascular and Tuberculosis Mortality: The Contrasting Effects of Changes in Two Causes of Death

Tuberculosis was the largest source of deaths among younger adults, and cardiovascular disease among older adults, in the America of 1900. Decreases in deaths from tuberculosis since 1900 and cardiovascular disease since 1940 explain most of the mortality drops in those age groups over the century. This article, building on previous work by White and Preston, shows the results of increased survival from these two causes on the US population structure. Standard demographic cause-specific mortality calculations are used to generate life tables without deaths from cardiovascular disease or tuberculosis. Then fixed rates for these diseases from early in the century are assumed while all other causes of death are allowed to change as they did historically. Improvements in cardiovascular mortality and tuberculosis produce some seemingly illogical contrasts. More people are alive today because of the decrease in tuberculosis. Yet more deaths from cardiovascular disease have been prevented, and cardiovascular improvements have raised life expectancy more. Lower tuberculosis mortality had virtually no effect on the average age of the population. Lower cardiovascular mortality alone has raised that average more than all twentieth-century causes of improved mortality combined.     

世界人口达到63亿，总体已进入老龄化社会——世界人口的最新动态

本文分析了世界人口的最新动态--世界人口达到63亿,总体已进入老龄化社会,并指出了发展中地区和发达地区在人口变化方面存在的差异。     

人口因素对公共医疗服务效率的影响——区域差异与动态变化

本文基于2002～2010年我国31个省市的面板数据,在DEA—Tobit两阶段分析框架下研究了人口因素对我国区域公共医疗服务效率的动态影响。首先,通过数据包络分析方法（DEA）测算了各省份医疗卫生体系的综合技术效率、纯技术效率和规模技术效率。在此基础上,利用受限因变量Tobit模型对效率值及人口规模、人口密度、受教育程度、城市化率等人口因素之间的关系进行了检验。研究结果表明：人口规模、人口密度与医疗体系的综合服务效率显著正相关,尽管受教育程度和城市化率与综合效率关系并不明显,但是对医疗体系的规模效率和纯技术效率仍然存在显著影响。     

我国高龄老人长期护理需求测度及保障模式选择

伴随着人口老龄化,我国老年人口高龄化现象日渐突出。高龄老人失能概率高．长期护理需求大．是老年人口中的脆弱群体。本文基于MarkOV多状态转移模型．对我国高龄老人长期护理需求进行量化预测。结果表明．2010--2050年我国失能高龄老人人口规模将从860．47万人激增至4764．52万人．高龄老人长期护理费用从1020．47亿元攀升至5650149亿元。昂贵的长期护理费用致使传统以家庭为主体的长期护理模式难以为继．为有效缓解未来高龄老人长期护理财务压力,满足高龄老人长期护理服务需求,发展长期护理保险与提升长期护理服务水平成为契合我国现实国情的政策方略．     

The Movement Beyond (Lifestyle) Migration: Mobile Practices and the Constitution of a Better Way of Life

Abstract

This article revisits my ethnography of the British in rural France to question how mobility in post‐migration life was deemed intrinsic to the better way of life that they sought through their migration. Through the exploration of the migrants’ everyday lives, I reveal that the migrants’ mobile practices and their expectations of mobility contributed towards the perceived success of their new lives and were thus significant to the ongoing process getting to a better way of life. Beyond this example, the article also demonstrates how the findings of mobilities researchers may be mobilized in traditional anthropological fieldwork.     

广东侨乡国内移民的崛起及其影响——台山市浮石村调查

台山有数量庞大的海外移民,他们主要来源于农村,对当地农村发展有重要的影响,一直受到较多的关注,而当地农村的国内移民却往往被忽视。改革开放以来,国内移民的数量大幅增加,而且随着个体经济实力上升、人脉力量突显等原因,整体实力不断提升,对农村经济发展、社会网络扩展、村民心态等都有重要的影响,成为侨乡的“新推手”。     

Complicating the Coming Out Narrative: Becoming Oneself in a Heterosexist and Cissexist World

Traditional stage models of LGBTQ identity development have conceptualized coming out as a linear process from “closeted” to “out” that all queer/trans individuals must follow if they are to be considered healthy and well adjusted. These stage models have been critiqued for their rigidity and absence of a dynamic understanding of the coming out process. In this article we explore the findings from a qualitative photovoice study with 15 LGBTQ youths in a small urban center in Ontario that supports these critiques. We explore the efficacy of the photovoice technique in investigating questions of sexual and gender identity. This article identifies some contextual factors that are important in understanding coming out as a social (rather than internal) process; it also identifies some of the ways in which these youths’ experiences challenge normative understandings of the “good, out queer.”