以人口健康观看我国健康保障制度改革

人口健康观是将健康的概念由个体健康拓展到以人口为基础的群体层面的一种新理念．它关注的是健康而不是疾病。从人口健康观看,我国健康保障制度改革存在着许多认识上的误区,应该以社区健康为中心重建健康保障制度。     

老年健康产业发展现状、规划与对策探讨

随着中国人口老龄化程度的加深,高龄老人的比重不断增加,老年人口的健康问题呈日益严重的趋势,已成为影响中国当前及未来社会经济发展的重大问题。健康是享受生活的前提,是影响老年人生活质量的最大因素之一,健康老龄化是老龄社会发展的重要目标,而老年健康产业的发展则是实现健康老龄化的前提。因此,弄清老年健康产业的内涵,大力发展老年健康产业,并积极构建政府、社会、社区和家庭有机结合的老年健康产业体系,对未来中国社会经济发展具有十分重要的意义。     

Good health and the bridging of structural holes

Bridges that span structural holes are often explained in terms of the entrepreneurial personalities or rational motivations of brokers, or structural processes that lead to the intersection of social foci. I argue that the existence and use of bridges in interpersonal networks also depends on individuals’ health. Poor health may make it more difficult to withstand the pressures and to execute some of the common tasks associated with bridging (e.g., brokerage). I examine this possibility using egocentric network data on over 2500 older adults drawn from the recent National Social Life, Health, and Aging Project (NSHAP). Multivariate regression analyses show that both cognitive and functional health are significantly positively associated with bridging, net of sociodemographic and life-course controls. The relationship between functional (kinesthetic) health and bridging appears to be partially mediated by network composition, as older adults who have poorer functional health also tend to have networks that are richer in strong ties. Several potential mediation mechanisms are discussed. Cognitive function remains significantly associated with bridging net of network composition, suggesting that the inherent challenges of maintaining bridging positions may be more difficult to cope with for those who have cognitive impairments than for those who have functional impairments such as limited mobility. An alternative explanation is that cognitively impaired individuals have more difficulty recognizing (and thus strategically using) bridges in their networks. Theoretical implications and possibilities for future research are discussed.     

Former Minister Zhang's discourse on SARS: Government's image restoration or destruction?

This study analyzes the image repair discourse by Chinese Health Minister Zhang Wenkang's discourse on SARS. The minister faced several accusations: the SARS outbreak was growing, the Chinese government had covered up the severity of this problem, the Chinese government ignored Taiwanese who suffered from SARS, and the Health Ministry provided information that was neither timely nor accurate. He employed several image repair strategies (denial, defeasibility, bolstering, minimization, differentiation, attack accuser, and corrective action). However, his messages were contradictory and apparently related on false information, so his efforts were unsuccessful and he was stripped of his office.     

不平等的再生产：从社会经济地位到健康不平等--基于CFPS2010的实证分析

本文利用2010年中国家庭追踪调查（ CFPS ）数据,探索性分析了社会经济地位影响健康不平等的两个中介机制－－健康预防机制和健康恢复机制。研究结果表明,健康预防机制中,社会经济地位影响生活方式,进而影响自评健康水平的假设得到部分验证,其中营养水平的中介效应得到验证;健康恢复机制中,社会经济地位影响医疗保健能力,进而影响自评健康水平的假设得到部分验证,其中医疗保健支付能力的中介效应得到证明。最后,分析发现,＂看病贵＂比＂看病难＂更能影响民众的健康状况。     

Seclusion,decision-making power,and gender disparities in adult health: Examining hypertension in India

Research on the social determinants of health in developing countries is increasingly focusing on the importance of gender. Cardiovascular conditions such as hypertension are a growing concern in developing countries, where they are now the leading cause of death. Researchers have documented differences in hypertension between men and women, but the importance of gendered practices in shaping these differences has been left unexamined. Using national data from the India Human Development Survey 2005 (N = 101,593), this study assesses the moderating role of two salient and widespread gendered practices—women’s seclusion and decision-making power—on hypertension disparities between women and men. Both seclusion and low decision-making power are associated with increased odds of hypertension for women, but in the case of seclusion reduced hypertension for men. Results also show the gender gap in hypertension is exacerbated with women’s seclusion and low decision-making power.     

Administration of daily 5 mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia

Introduction: Tadalafil is a promising phosphodiesterase (PDE) 5 inhibitor prescribed for erectile dysfunction (ED). Daily low dose (5?mg) of tadalafil has also been used for the treatment of male lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). PDE5 inhibitors induce relaxation of smooth muscle cells in the urethra, prostate, bladder neck, and blood vessels. The aim of this study was to investigate the efficacy of tadalafil on vessels endothelial function, in patients with male LUTS symptoms associated with BPH.

Methods: The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 81 BPH patients.

The following male LUTS parameters: international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), voiding volume, max and mean voiding flow on voiding flowmetry examination and post-voiding residual urine (RU) were compared at 0, 1, 3, 6, and 12 months after a daily dose of 5?mg tadalafil.

In addition, erectile function was evaluated by the sexual health inventory for men (SHIM) score and vessels endothelial function and peripheral neuropathy were assessed by the brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), and vibration perception threshold (VPT) at 0, 3, 6, and 12 months after treatment.

Results: The mean age of 81 patients was 66.4?±?11.4 years old. Their prostate size was 30.2?±?22.1?ml.

Male LUTS parameters including IPSS, OABSS, and RU showed significant improvement from 1 to 12 months after tadalafil administration. Max and mean voiding flow was significantly increased at 6 months after tadalafil treatment.

The SHIM score showed significant improvement after 3 months. Whilst, the results of baPWV also showed significant improvement from 3 to 12 months. ABI was also significantly improved at 6 months. However, there was no change in the VPT at any time point.

Conclusions: Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.     

Impact of metabolic status on the association of serum vitamin D with hypogonadism and lower urinary tract symptoms/benign prostatic hyperplasia

Objective: The objective of this study is to investigate the impact of metabolic status on associations of serum vitamin D with hypogonadism and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).

Patients and methods: A total of 612 men underwent physical examination, biochemical/hormonal blood testing, and transrectal prostate ultrasound. Moreover, the subjects filled out standard questionnaires for identification and grading of LUTS and hypogonadism symptoms. Parameters were statistically compared with independent t-tests and correlation analyses.

Results: Vitamin D levels positively correlated with total testosterone (TT) but not with prostate volume or International Prostate Symptom Score (IPSS). Patients with metabolic syndrome had significantly lower vitamin D levels, which were not correlated with TT, prostate volume, or IPSS. However, vitamin D was positively correlated with TT, and negatively correlated with prostate volume and quality-of-life IPSS in subjects without metabolic syndrome.

Conclusion: The clinical usefulness of vitamin D for treatment of hypogonadism or LUTS/BPH varies according to metabolic status.     

The relationship between the community participation of disabled youth and socioeconomic factors: mixed-methods approach in rural Sri Lanka

Mixed methods were applied to examine the association of community participation by disabled youth with socioeconomic factors in rural Sri Lanka. There was a significant association between community participation and socioeconomic factors in the quantitative survey (n = 116): participants living in socioeconomically disadvantaged conditions had lower levels of community participation than those living without these disadvantages. Consistent with the findings of the survey, previous educational experiences, household economic conditions, and perceived resource information were common themes in the qualitative study (n = 26). The dynamics of these factors, including marginalisation of disabled youth within the household, were also observed.     

The impact of age,BMI and sex hormone on aging males’ symptoms and the international index of erectile function scores

Objective: To analyze the impact of age, BMI and sex hormone on aging males’ symptoms (AMS) and the 5-item version of the international index of erectile function (IIEF-5) scores in middle-aged and elderly Chinese men.

Methods: A population-based cross-sectional study was conducted in Jiashan County. A total of 969 men, aged between 40 and 80 years old, were admitted. Physical examination and the sex hormones were measured, and AMS and IIEF-5 scores were assessed.

Results: The oneway ANOVA analysis indicated older age groups had higher AMS total-scores, somatic and sexual sub-scores, and lower IIEF5 scores (all p?r_pairwise) analyses showed the significant associations between AMS and age or sex hormone (cFT, Bio-T, SHBG, and LH) levels, and similar for IIEF5. However, when age was adjusted, the correlation coefficients (r_partial) weakened, and correlation significance disappeared, except LH (for AMS: r_partial?=?0.096, p?=?.009; for IIEF-5: r_partial?= ?0.140, p?=?.001). Multiple linear regressions confirmed the influence of increased age and LH on the AMS and IIEF5 scores.

Conclusion: CFT, Bio-T and SHBG failed to yield any additional predicting information when age was adjusted. To improve the male reproductive health, future research should pay more attention on aging-related comorbidities and how to improve general wellness.