Who cares and how much: exploring the determinants of co-residential informal care

The importance of informal care provided inside the household (co-residential care) is widely acknowledged in policy circles. However, the factors that determine the likelihood and scale of provision are not fully understood. A two-part model (2PM) is used to investigate both participation and levels of provision. Random effects dynamic panel specifications are employed. Results show that co-residential informal care competes with other time demanding activities, such as childcare and employment. Wealthier individuals are less likely to be caregivers, whereas wealthier households have a higher tendency towards caregiving. Evidence of both substitution and complementarity is found between formal and informal care. Informal care and health status are significantly related, with carers more likely to report worse General Health Questionnaire scores than non-carers. Finally, significant dynamic effects are observed with the continuance of the provision of informal care being more likely than the initiation of such activity, while heavy commitment in the past increases the hours provided in the current period.

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。     

城乡差异、就医惯性与老年人卫生服务利用

现有对城乡老年人卫生服务利用不公平的研究多忽略了长期的城乡差异所导致的隐性的农村老年人就医惯性的存在。本研究在控制了收入、医疗保障和就医可及性等因素的条件下,发现就医惯性的存在;并运用集中指数分解法发现,卫生服务的利用存在不公平,偏向于富人,而就医惯性在两种卫生服务利用中的贡献度分别为12%和5%。这种城乡固定差异造成了农村老年人在身体健康、心理健康和自我照料能力上都显著地低于城市老年人。     

新医改背景下医科大学生价值取向变化趋势及教育引导研究

新医改的价值目标是公益性,对于当前医科大学生价值取向的产生、形成具有重要导向作用。当前医科大学生价值取向出现了价值目标趋于功利化、迷失医学真正目的;医学技术至上、自身技术能力下滑;科研作风不够严谨,人文素质滑坡等趋势。因此,应从树立崇高职业理想,提升使命感和责任感;创新医德教育体系,强化思想政治教育育人功能;关注物质精神需求,提高从医幸福感等方面教育引导医科大学生树立正确价值取向。     

Substance use among older youth transitioning from foster care: Examining the protective effects of religious and spiritual capital

Among older youth transitioning from the foster care system, this longitudinal study examined the association of religious and spiritual capital to substance use in the past year at age 19. Participants consisted of African American (N = 179) and White non‐Hispanic (N = 133) older youth in foster care. Drawing from social capital theory, it was posited that religious service attendance (a proxy for religious capital) and belief in a spiritual force (a proxy for spiritual capital) would be inversely associated with substance use. Multiple logistic regression results indicated support for the first and second hypothesis for White foster youth only. Among White foster youth, more frequent religious service attendance and greater belief in a spiritual force were associated with a lower likelihood of illegal substance and polysubstance use. No association between religious or spiritual capital and substance use was found among African American foster youth. The findings underscore the importance of conducting spiritual assessments to help ensure older foster youth who have strong religious or spiritual orientations are in environments where they are accommodated and supported.     

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.     

The sacred and the profane in life science work: The case of assisted reproduction laboratories

Reproductive medicine and assisted reproduction therapies have been developed over the last decades resulting in over five million babies. The handling of human reproductive materials and patients is based on the ability to combine health care work and techno-scientific expertise in both the clinic and the laboratory setting. This study of Swedish assisted reproductive technology clinics demonstrates that the active day-to-day manipulation of human reproductive materials enact both the ‘profane’, through treating the embryos as raw materials in standardized procedures enabling economies of scale, and the ‘sacred’ through enacting a separation, the potential to human life, the patients ordeals, and seriousness. The enactment of the profane and the sacred is mostly balanced but at certain points in the work procedures, their intersecting becomes particularly salient. Such points provide opportunities for the study of the sense making of professionals in organizational grey zones, during techno-scientific activities.     

Identity Formation in Children and Young People in Open Adoptions from Out-of-home Care in New South Wales,Australia

Semi-structured interviews were used to explore identity development for nine adoptees (aged 9–23 years) who were adopted by their foster carers in New South Wales, Australia. Adoptions were open, with court-ordered face-to-face contact with birth families. Findings suggest that participants had healthy adoptive identities, with coherent and meaningful narratives about their life histories. Adoption provided a sense of security and belonging. Openness provided information to build a self-narrative and encouraged discussion of adoption issues within adoptive families. Adoptive parents were critical in helping children understand their adoption and facilitating direct contact with birth families, thus laying foundations for positive identity development.     

Correlates of Depressive Symptoms among Homebound and Semi-Homebound Older Adults

ABSTRACT

This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults was selected from Round 1 of the National Health and Aging Trends Study (NHATS). The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively. Nearly two-thirds of homebound and over half of semi-homebound older adults with clinically significant depressive symptoms also had significant anxiety symptoms. Results from logistic regression showed that younger age, certain medical morbidities, severity of functional limitations, and pain were common risk factors for depressive symptoms among homebound and semi-homebound older adults. Some differences in the risk factor profile emerged between the homebound and the semi-homebound populations. Alleviating the burden of depression in the semi-homebound population may focus on early prevention that considers the diversity of this population. Home-based, integrated programs of health and mental health services that simultaneously address the medical, psychiatric, and neurologic comorbidities and disabilities of homebound older adults are needed to meet the complex needs of this population.