Quality of Life in Older Adults: Benefits from Caring Services in Hong Kong

Many older adults are in need of care. Therefore, older people would generally benefit from the use of caring services, notably including home care, residential care, nursing, and medical services. The contributory factors underlying caring services tend to be a caring perspective that aspires to sustain older people’s social relationships and real-life involvement. To gauge the benefits from various social and health services, the present study relies on a large-scale survey of 3000 older adults in Hong Kong, using quality of life as a criterion. Results showed that an older adult who had used (ordinary or enhanced) home care services for a longer time turned out to have appreciably more improvement in quality of life. Besides, those who joined an interest group more frequently were higher in quality of life, including the health domain. On the other hand, frequent use of medical and meal-to-home services were signals that reflected problems detrimental to the older user’s quality of life. Despite this, the quality of clinics or hospitals, as perceived by the older adult, was the most beneficial. As such, caring services that foster older adults’ interests, cater to their health care needs, and embody quality can have principal contribution to their users’ quality of life.     

儿童照料、劳动参与和中国已婚男女身心健康——基于城镇居民和外来务工人员的对比研究

本研究采用2008年国家统计局针对城镇居民和外来务工人员进行的调查数据，研究劳动参与、儿童照料双重责任对于城镇和移民已婚男女身心健康的影响。研究结果表明：在承担工作和儿童照料双重责任过程中城镇已婚男女几乎不存在性别差异，只工作就会增加其精神压力，工作、并且家中有7—12岁儿童对女性精神压力的边际影响最大，而男性则是工作、并且家中有0-6岁儿童对其影响最大：外来务工人员在承担工作和儿童照料双重责任过程中仍存在引人注目的性别差异，妇女仍然是儿童照料责任的主承担者，参与市场劳动并未减少其家庭责任。     

The influence of urine from asymptotic laboratory populations on sexual maturation in prairie deermice

Summary Male and female prairie deermice housed singly from weaning (21 days) until 40 days of age had urine from one of the following sources applied daily to their nostrils: sexually mature laboratory population males or females, and sexually mature breeder males or females from our laboratory colony. Other males and females were treated with water. Records were obtained of the weights of the tests, seminal vesicles and bacula of males and the ovaries and uteri of females at 40 days of age. The major results of this study were as follow: Female urine from sexually mature and inhibited population or isolated mice stimulated the development of the male reproductive organs significantly more than water or male urine. Male urine applied to young males did not differentially affect the weights of their reproductive organs compared with water and thus showed no inhibition effects. The reproductive organs of females treated with male urine did not differ significantly in weight from those of females treated with female urine. Females treated with water developed significantly larger uteri than those treated with urine from sexually mature population females (P≤0.02), inhibited population females (P<0.001) and inhibited population males (P<0.007).     

Reproductive behavior of the Japanese treefrog,Rhacophorus arboreus (Anura: Rhacophoridae)

Reproductive behavior of the foam-nesting treefrog,Rhacophorus arboreus, is described. Oviposition was made either by an amplectant pair (a female, and an amplectant male) alone or by an amplectant pair and other males (joiners). The snout-vent length of males and females was negatively correlated with the date of the first appearance in the pond. The period of staying in the pond in males was longer than that in females. Physical body contacts of other males, and encounter calls by ampletant males were frequently observed before oviposition with joiners. Snout-vent length of the female and an amplectant male were positively correlated. Encounter calls by amplectant males were likely to precede movement of females. There was no difference of snout-vent length between amplectant males and joiners. Females moved the hindlimbs more frequently than males during oviposition. Amplectant males made encounter cells more frequently in oviposition with joiners, than oviposition without joiners. The patterns of transitions between acts of females and amplectant males were similar between oviposition with and without joiners. Females more frequently responded to amplectant males than joiners. Both the duration of a bout of the movements of hindlimbs of females and the interval between the bouts were longer in oviposition without joiners than that with joiners. The number of the movements per bout in oviposition without joiners was smaller than that with joiners. Encounter calls by amplectant males during oviposition tended to precede the hindlimb movements of females.     

Health Care Service Needs and Correlates of Quality of Life: A Case Study of Elderly Chinese Immigrants in Canada

This study explored the health care service needs and the major correlates of quality of life among 127 community-dwelling elderly Chinese immigrants in a western Canadian city. Participants were interviewed in their homes by trained, bilingual interviewers employing a structured questionnaire that covered a wide range of topics including health care service needs, living arrangements, health status, social network, life satisfaction, and socio-demographic information. Results demonstrated that ethnic nursing homes, senior centres that provide programs and services, and homemaker services were respondents’ major service needs. Multiple ordinary least-squares regression analysis revealed that respondents who emigrated from Mainland China and those who exhibited greater psychological well-being, reported being physically more mobile, perceived fewer service needs, and expressed satisfaction with the quality of their neighbourhood demonstrated higher levels of life satisfaction.     

The relationship of self-reported sex-role characteristics and attitudes toward homosexuality

The present study investigated the relationship between self-reported sex-role characteristics and attitudes toward homosexuality using the Bem Sex Role Inventory, the Personal Attributes Questionnaire and the Attitudes toward Homosexuality Scale. Relationships occur for both males and females who are exhibiting greater amounts of cross-sex traits. Females with more instrumental characteristics were more accepting while males with more expressive characteristics were more rejecting. These findings are discussed in relation to those of Weinberger and Millham (1979) who also investigated this relationship, as well as to research investigating the relationship between attitudes toward homosexuality and attitudes toward sex roles and feminism.     

Differentials in Adult Mortality and Activity Limitation by Years of Education in the United States at the End of the 1990s

This study examines mortality differentials and health disparities between educational groups within the 1998 adult population (ages 25 and older) in the United States. Mortality differentials are measured using average life expectancy and health disparities by expected years without activity limitation. The results indicate that for both sexes, higher education is associated with higher life expectancy. Those with higher levels of education also have higher life expectancy without activity limitation. Adults with higher education can also expect to enjoy a greater percentage of their expected lives free of any form of activity limitation. At each level of education, adult females have a higher level of activity limitation compared to adult males. At the same level of education, adult females expect to enjoy smaller percentages of their remaining lives free of activity limitation compared to adult males of the same age.     

The effects of child health on marital status and family structure

The purpose of this paper is to provide evidence on the effect of child health on marital stability and family structure in an economic framework. We use the 1988 National Health Interview Survey's Child Health Supplement, with a sample of about 9,000 families, to test whether having an unhealthy child decreases the mother's chance of being married and whether it increases her chance of living in an extended family. Using two different measures of child health, we find that having an unhealthy child decreases the mother's likelihood of being married. Our results imply that children in poor health are more likely to face obstacles beyond their illness because they also are more likely to suffer the consequences of poverty and the poor schooling outcomes that result from being raised in a female-headed household. The only mitigating factor is that unhealthy white children are more likely than their healthy counterparts to be living in an extended family.     

Aging in America: Limits to life span and elderly care options

Expanding longevity among the elderly and fertility decline are contributing to an aging US population. The number of persons 65 years or older is projected to double from about 32 million in 1990 to 66 million by 2030; the elderly proportion is expected to increase from 13 to 22 percent over the same period. Chronic illness and functional disability afflicts a significant proportion of older persons. An estimated 80–85 percent of people over age 65 have at least one chronic illness, and nearly one-half of older people report that chronic illness limits their activity to some degree. Altogether, about one-third of the population over 65 may need some kind of medical or social assistance. This paper discusses the three primary modes of care available to older persons: (1) the informal network of the family, (2) the more formal arrangements of home and community care, and (3) the institutionalized care of nursing homes. Of particular policy interest are the questions: Who provides the care? What type of care is available? Who receives the care? How much does each type of care cost? and Who pays? The current patterns and costs especially of long-term care provide a framework for planning future options. A discussion of research and policy recommendations concludes the paper.     

中国高龄老人就医及时性状况研究

基于 1 998年中国高龄老人健康长寿调查数据 ,对中国高龄老人患病能否得到及时医治的状况进行了分析。结果表明 ,高龄老人调查当时若患病 ,只有 3 7%左右的高龄老人不能得到及时医治 ;农村 (4 2 % )该比例略高于城镇 (3 0 % ) ;患病得不到及时就医的群体比较固定。LOGISTIC回归还揭示患病由家庭成员提供照料服务的高龄老人比由社会提供照料服务的高龄老人得不到及时医治的可能性小 ,与患病不能及时医治的高龄老人相比 ,患病能得到及时医治的高龄老人健康自评好的比例高 ,完全自理的比例高 ,认知健全比例高 ,疾病对日常生活妨碍比例小 ,隶属健康纯类的可能性大 ,其后死亡的可能性小 ,健康存活的可能性大。说明患病得到及时治疗对高龄老人晚年健康促进和生存具有一定的影响。     

Perceptions of Caregivers of Elderly Parents by College Students:

College students (144 females and 96 males) evaluated a briefly depicted stimulus person on 31 7-point bipolar scales that described personality traits, job performance characteristics and role overload variables. Each participant rated one of eight employed married adults who was described as either female or male, eithcr providing care for an elderly mother ("primary caregiver") or hiring someone to provide such care ("secondary caregiver"), and as having two children who either still lived or no longer lived at home. Women were viewed as experiencing more role overload than men. Primary caregivers were perceived as experiencing more role overload, as being less job-oriented, and as being more nurturant than secondary caregivers.     

Quality of Life in Older Adults: Benefits from Caring Services in Hong Kong

Many older adults are in need of care. Therefore, older people would generally benefit from the use of caring services, notably including home care, residential care, nursing, and medical services. The contributory factors underlying caring services tend to be a caring perspective that aspires to sustain older peoples social relationships and real-life involvement. To gauge the benefits from various social and health services, the present study relies on a large-scale survey of 3000 older adults in Hong Kong, using quality of life as a criterion. Results showed that an older adult who had used (ordinary or enhanced) home care services for a longer time turned out to have appreciably more improvement in quality of life. Besides, those who joined an interest group more frequently were higher in quality of life, including the health domain. On the other hand, frequent use of medical and meal-to-home services were signals that reflected problems detrimental to the older users quality of life. Despite this, the quality of clinics or hospitals, as perceived by the older adult, was the most beneficial. As such, caring services that foster older adults interests, cater to their health care needs, and embody quality can have principal contribution to their users quality of life.     

Midwife readiness to provide woman-centred weight gain support: Exploring perspectives across models of care

ProblemMore than half of women start pregnancy above a healthy weight and two-thirds gain excess weight during pregnancy, increasing the risk of complications.BackgroundLittle research has examined the influence model of care has on weight-related outcomes in pregnancy.AimTo explore how continuity vs non-continuity models of midwifery care influence perceived readiness to provide woman-centred interventions with women supporting pregnancy weight gain, healthy eating and physical activity.MethodsFocus groups were conducted with midwives working in either continuity or non-continuity models of care at a tertiary hospital in Queensland, Australia. Focus group questions elicited elements around practices, the healthcare environment and woman-centred care skills. Findings were analysed using the Framework Approach to qualitative research.FindingsFour focus groups, involving 15 participants from the continuity of care model and 53 from the non-continuity model, were conducted. Continuity of care participants reported greater readiness to provide woman-centred interventions than those from non-continuity models. Barriers faced by both groups included gaps in communication training, education resources and multidisciplinary support.DiscussionMidwives across models of care require greater support in this area, in particular training in communication and better multidisciplinary service integration to support women.ConclusionThe care model appears to influence capacity to deliver person/woman-centred interventions, highlighting the need for tailored training for the healthcare setting. The roles of other health professionals in delivering weight management interventions during pregnancy also need to be examined.     

Longevity, flight ability and reproductive performance of the diamondback moth,Plutella xylostella (L.) (Lepidoptera: Yponomeutidae), related to adult body size

Plutella xylostella in the temperate zone shows a clear seasonal change in adult body size. In the laboratory, large and small moths were produced during immature stages at 15°C and 25°C, respectively. These moths were then used to evaluate longevity, age-specific flight ability, flight ability of mated and unmated females, and the influence of flight experience on the subsequent reproductive success. The large moths lived longer and displayed a greater flight ability over 3 weeks. Irrespective of body size, unmated females flew for a longer time than mated females, and flight experience affected their subsequent reproductive success. Females of both sizes mated and laid eggs soon after emergence, without any obvious pre-reproductive period. More flight experience did not delay oviposition, but did reduce egg production. It is likely that large moths with a longer adult life span and greater flight ability are better fitted for long-distance flight and more fecund than small ones. These experimental results may explain why long-distance migration ofP. xylostella is mostly seen during cool seasons, when relatively large moths with long forewing appear in the field.     

Caregiving and Care-Receiving:

Many aspects of aging are women's issues. Yet research on aging has, until recently, focussed little attention of gender differences in the experience of growing old. Older women are more likely than older men to be poor, widowed, living alone in poor health, receiving assistance from both formal and informal supports, as well as being institutionalized in long-term care facilities. This secondary analysis of data from the 1982 Survey of the Elderly in the Waterloo Region attempts to address a gap in our knowledge concerning gender differences in the giving and receiving of social support in later years. Gender differences in (1) need for social support, (2) turning to formal assistance, (3) amount of formal assistance used, and (4) amount of informal assistance received were examined using analysis of variance and logistic regression procedures. The profile of social support that emerged suggests both similarities and differences in the way elderly men and women experience the giving and receiving of social support. Older women in this sample were found to be disadvantaged in the areas of income, health, years lived alone, and loneliness, relative to older men. Low-income was related to formal service use for older women, but not for older     

Health Care Needs and Care Utilization Among Lesbian,Gay, Bisexual,and Transgender Populations in New Jersey

The purpose of this study was to explore prevalent health issues, perceived barriers to seeking health care, and utilization of health care among lesbian, gay, bisexual, and transgender (LGBT) populations in New Jersey. A cross-sectional online survey was administered to 438 self-identified LGBT people. Results identified health needs, which included management of chronic diseases, preventive care for risky behaviors, mental health issues, and issues related to interpersonal violence. Barriers to seeking health care included scarceness of health professionals competent in LGBT health, inadequate health insurance coverage and lack of personal finances, and widely dispersed LGBT inclusive practices making transportation difficult. There is a need for better preparation of health care professionals who care for LGBT patients, to strengthen social services to improve access and for better integration of medical and social services.     

Indonesian survey looks at adolescent reproductive health

The Baseline Survey of Young Adult Reproductive Welfare in Indonesia, conducted from September to December 1998, provides information about young Indonesians on topics concerning work, education, marriage, family life, sexuality, fertility, and HIV/AIDS and other sexually transmitted diseases. The survey interviewed 4106 men and 3978 women aged 15-24 years in three provinces of Java. Survey findings showed that 42% of the women and 8% of the men are currently or have been married. There was a strong inverse relationship between marriage and schooling, which suggests that greater educational attainment and a higher average age at marriage are likely to go together. Although most young couples prefer to delay and space births, only half of currently married young women are using any type of contraception. These results indicate that there is a need for better reproductive health care as well as improved reproductive health education. Moreover, the current economic crisis has lead to a decline in the use of the private sector for health care. Instead, young people are using the less-expensive government services, and young women are turning to pharmacies and midwives rather than to private doctors to obtain contraceptives. These findings have several policy implications including the need for reproductive health programs that provide services needed by young people.     

Parents' supportive reactions to sexual orientation disclosure associated with better health: results from a population-based survey of LGB adults in Massachusetts

This study investigated associations between coming out to parents, experiences of parental support, and self-reported health behaviors and conditions among a population-based sample of LGB individuals using data collected via the 2002 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS; N = 177). We explored the following two hypotheses: 1) Lesbian, gay, and bisexual (LGB) individuals who had never disclosed their sexual orientation to a parent would report higher levels of risk behaviors and poorer health conditions than those who had come out; and 2) among LGB respondents who had come out to their parents, the individuals whose parents had reacted unsupportively would report higher levels of risk behaviors and poorer health conditions than those who had come out to parents who were supportive. Approximately two thirds of gay and bisexual (GB) males and lesbian and bisexual (LB) females reported receiving adequate social and emotional support from the parent to whom they first disclosed their sexual orientation. Among LB females, no disclosure of sexual orientation to a parent was associated with significantly elevated levels of past-month illicit drug use (AOR 12.16, 95% CI 2.87-51.54), fair or poor self-reported health status (AOR 5.71, 95% CI 1.45-22.51), and >15 days of depression in the past month (AOR 5.95, 95% CI 1.78-19.90), controlling for potential confounders. However, nondisclosure to a parent by GB males was not associated with greater odds of any of the health indicators assessed. Among GB males, those with unsupportive parents were significantly more likely to report current binge drinking (AOR 6.94, 95% CI 1.70-28.35) and >15 days depression in the past month (AOR 6.08, 95% CI 1.15-32.15), and among LB females, those with unsupportive parents were significantly more likely to report lifetime illicit drug use (AOR 11.43, 95% CI 2.50-52.30), and >15 days depression in the past month (AOR 5.51, 95% CI 1.36-22.36). We conclude that coming out may be associated with better health for LB women, and that parents who react nonsupportively when their children disclose LGB sexual orientation may contribute to children's increased odds of depression and hazardous substance use.     

Satisfaction and happiness in a rural northern resource community

Satisfaction and happiness with life as a whole are analyzed in terms of satisfaction with health, finances, family, job, friends, housing, area, recreation, religion, self-esteem, transportation and government services for males and females. Patterns of influential variables differ for males and females. The perceived gap between what one has and wants is a better predictor of satisfaction than the gap between what one has and thinks similar others have, and the gap between what one has and the best one has had in the past. Domain-to-satisfaction and happiness explanations are combined with gap theoretic explanations to reveal the psychological dynamics of judgments of satisfaction for males and females for the 12 domains and global well-being.     

政府支出对医疗服务健康公平影响的比较和启示

医疗服务公平和人民的健康是各国卫生系统向其国家居民提供医疗服务所应实现的两个重要目标。但以英美日为例的发达国家根据世界卫生统计年鉴中的医疗服务公平性排名确有明显差距,因此,高收入和高政府医疗卫生支出与医疗卫生服务公平和健康公平性并没有必然关系。本文通过比较分析美日英国的政府间医疗卫生支出责任划分的结构发现高政府医疗卫生支出比例是提高医疗服务筹资公平性的前提,中央承担社会医疗保险责任是实现医疗服务筹资公平性的保证,政府特别是中央政府出资的长期护理有助于提高国民健康水平,地方政府的参与更有助于提高一国医疗系统机构数量特别是医院的数量。