Social Problems

社会问题
  • 文章类型: Journal Article
    先前的横断面研究表明,出生体重(BW)与侵袭有关,男孩和女孩的社会和注意力问题不同。我们试图测试这些差异是否可以在纵向研究中得到证实。1989年的Raine研究提供了有关围产期变量的前瞻性收集数据,以及5至17岁儿童的重复行为清单评估。线性混合效应模型使用调整模型中的产前母体协变量,以保守的显著性阈值提供了BW与儿童行为之间的粗略和调整的关系。敏感性分析包括10岁教师评估。行为数据,BW和性别,在2269名参与者中可用。与原始模型中的女性相比,男性在较低体重时与侵略问题增加有关(相互作用B:-0.436,98.3CI:[-0.844,-0.0253]),但不是调整后的模型(相互作用B:-0.310,98.3CI:[-0.742,0.140])。在粗模型(相互作用B:-0.334,98.3CI:[-0.530,-0.137])和调整后的模型(相互作用B:-0.274,98.3CI:[-0.507,-0.0432])中,与女性相比,男性在较低体重时的注意力问题增加。在粗模型(交互作用B:-0.164,98.3CI:[-0.283,-0.0441])和调整后的模型(交互作用B:-0.148,98.3CI:[-0.285,-0.00734])中,与女性相比,男性在较低体重下的社会问题增加。使用5-17岁的反复措施,我们能够显示出在注意力问题和社会问题的发展中,男性对较低体重的脆弱性。我们没有发现BWx性别相互作用来发展攻击行为。
    Previous cross-sectional studies suggest that birth weight (BW) is associated with aggression-, social- and attention problems differently in boys and girls. We sought to test if these differences could be confirmed in a longitudinal study. The 1989 Raine Study provided prospectively collected data on perinatal variables and repeated child behaviour checklist assessments from ages 5 to 17. Linear mixed effects models provided crude and adjusted relationships between BW and childhood behaviour at a conservative significance threshold using prenatal maternal covariables in adjusted models. Sensitivity analyses included an age10 teacher assessment. Data on behaviour, BW and sex, was available in 2269 participants. Male sex was associated with increased aggression problems at lower BW compared to females in the crude model (Interaction B: -0.436, 98.3%CI: [-0.844, -0.0253]), but not the adjusted model (Interaction B: -0.310, 98.3%CI: [-0.742, 0.140]). Male sex was associated with increased attention problems at lower BW compared to females in both the crude model (Interaction B: -0.334, 98.3%CI: [-0.530, -0.137]) and the adjusted model (Interaction B: -0.274, 98.3%CI: [-0.507, -0.0432]). Male sex was associated with increased social problems at lower BW compared to females in both the crude model (Interaction B: -0.164, 98.3%CI: [-0.283, -0.0441]) and the adjusted model (Interaction B: -0.148, 98.3%CI: [-0.285, -0.00734]). Using repeated measures from ages 5-17 we were able to show a crude and adjusted male vulnerability to lower BW in the development of attention problems and social problems. We did not find a BW x sex interaction for the development of aggressive behaviour.
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  • 文章类型: Journal Article
    目标:预期寿命和过早死亡率是全球健康和社会公平的基本标志,以及无家可归的人面临巨大差距的措施。然而,与其他具有类似差异的人口群体不同,政府采取一致行动降低无家可归者死亡率的情况很少见,部分原因是缺乏可靠,及时的数据。需要同时跟踪无家可归者的死亡,以减少此类死亡的不可见性,并衡量随时间的趋势。根据美国国家卫生保健委员会开创性的无家可归者死亡率数据工具包的建议,利用多个数据源,我们经常同时捕获,核实和报告在澳大利亚珀斯市经历过无家可归的人中发生的死亡。
    方法:动态队列研究。
    方法:珀斯,西澳大利亚,澳大利亚,在2016年至2022年之间,在2020年至2022年之间检查了死亡人数。
    方法:对于本研究,该队列包括在珀斯经历过无家可归的8753人,在这段时间内,“招募”进入队列,由一个或多个当地无家可归服务和计划的参与管理。
    方法:数字和中位死亡年龄统计。
    结果:3年期间有360人死亡,这可能是一个低估。死亡年龄中位数是50岁,比目前澳大利亚82岁的中位死亡年龄低30年。原住民占死亡人数的30%。
    结论:经历过无家可归者的持续健康状况不佳和过早死亡是对我们社会的起诉。需要对多个数据源进行三角测量,以识别和监测无家可归者中的死亡人数。及时,关于无家可归者死亡率的经过验证的数据对于激励行动和问责至关重要,并应设定目标以减少观察到的三十年预期寿命鸿沟。
    OBJECTIVE: Life expectancy and rates of premature death are fundamental markers of health and social equity globally, and measures on which people experiencing homelessness face enormous disparities. However, unlike for other population groups with similar disparities, concerted government action to reduce homeless mortality is rare, partly due to a lack of reliable, timely data. Contemporaneous tracking of homeless deaths is required to render such deaths less invisible and measure trends over time. Drawing on multiple data sources as recommended by the US National Health Care for the Homeless Council\'s seminal Homeless Mortality Data Toolkit, we routinely and contemporaneously capture, verify and report on deaths occurring among people who have experienced homelessness in the Australian city of Perth.
    METHODS: Dynamic cohort study.
    METHODS: Perth, Western Australia, Australia, between 2016 and 2022, with deaths examined between 2020 and 2022.
    METHODS: For this study, the cohort comprised 8753 people who experienced homelessness in Perth, with \'recruitment\' into the cohort governed by engagement with one or more local homelessness services and programmes over the period.
    METHODS: Number and median age-at-death statistics.
    RESULTS: There were 360 deaths over the 3-year period, which is likely an undercount. The median age at death was 50 years, >3 decades below the current Australian median age at death of 82 years. Aboriginal people accounted for 30% of the deaths.
    CONCLUSIONS: The ongoing poor health and premature death of people who have experienced homeless are indictments on our society. Triangulation of multiple data sources is required to identify and monitor deaths among homeless populations. Timely, verified data on homeless mortality are important for galvanising action and accountability, and targets should be set to reduce the observed three-decade life expectancy chasm.
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  • 文章类型: Journal Article
    背景:这项研究的目的是讨论无家可归危机的问题,并提出对经历无家可归危机的人的生活质量的评估,考虑到生活和日常运作的各个方面。
    方法:这是一项使用匿名调查进行的试点横断面研究。作者的问卷,使用WHOQOL-Bref量表和Beck抑郁量表。在波兹南市为无家可归危机中的人们提供的支持中心中,选择了两个最大的中心。获得的结果基于对收集的数据的统计分析。
    结果:研究小组仅由处于无家可归危机中的人组成,这些人在研究时留在支持中心。分析包括114人的数据,包括28名(24.6%)女性。最年轻的参与者21岁,最年长的76岁。无家可归的平均时间为86个月。55.3%的受访者表现出抑郁症状。无家可归的主要原因是他们的家庭状况(59.6%),财务问题(36.0%)和离开公寓的需要(13.2%)。96名(84.2%)受访者报告了无家可归危机之前的酒精滥用情况。使用WHOQOL-Bref问卷评估生活质量。心理领域评分最高(62.09±16.94分,最低的体细胞域(53.25±18.71分)。无家可归者的生活质量与其经济状况呈正相关,抑郁症和健康状况。它表明性,年龄和教育程度对无家可归危机患者的生活质量评估没有影响(p>0.05)。
    结论:经济状况是影响心理和社会领域生活质量的主要因素。健康状况是影响躯体和环境领域内生活质量的主要因素。受访者最大的梦想是有一个平坦的,改善他们的财务状况。
    BACKGROUND: The aim of the study was to discuss the issues of the homelessness crisis and to present the assessment of the quality of life of people experiencing a homelessness crisis, taking into account various aspects of life and everyday functioning.
    METHODS: This was a pilot cross- sectional study carried out using an anonymous survey. The author\'s questionnaire, the WHOQOL-Bref scale and the Beck depression scale were used. From among the support centers for people in the homelessness crisis operating in the city of Poznań, the 2 largest centers were selected. The obtained results were based on the statistical analysis of the collected data.
    RESULTS: The study group consisted only of people in the crisis of homelessness staying at the support centers at the time of the study. The analysis included data from 114 people, including 28 (24.6%) women. The youngest participant was 21 and the oldest 76 years old. The average period of homelessness was 86 months. 55.3% of respondents showed symptoms of depression. The main cause of homelessness was their family situation (59.6%), financial problems (36.0%) and the need to leave the apartment (13.2%). Abuse of alcohol before the homelessness crisis was reported by 96 (84.2%) respondents. The WHOQOL- Bref questionnaire was used to assess the quality of life. The psychological domain was rated the highest (62.09 ± 16.94 points, the lowest somatic domain (53.25 ± 18.71 points). The quality of life of homeless people was positively related to their economic situation, depression and health status. It was shown that sex, age and education had no influence (p > 0.05) on the assessment of the quality of life of people experiencing the crisis of homelessness.
    CONCLUSIONS: The economic situation is the main factor affecting the quality of life within the psychological and social domain. Health status is the main factor affecting the quality of life within the somatic and environmental domain. The biggest dream of the respondents was to have a flat and improve their financial situation.
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  • 文章类型: Journal Article
    分析与就业形势有关的舆论,提出了一种组合方法来研究社交媒体的有价值的想法。首先,从统计的角度根据时间序列分析了舆论的流行程度。其次,对舆情信息进行特征提取,并基于潜在狄利克雷分配模型对就业环境进行了专题分析。第三,采用Bert模型对就业相关舆情数据进行情绪分类和趋势分析。最后,基于空间序列流行度分析,研究了不同地区的就业舆情文本,关键词差异分析。在中国进行了案例研究,以验证所提出的组合方法的有效性。结果显示,2022年3月,就业舆论的热度达到最高水平。公众对就业形势的看法是负面的。不同省份就业舆论的流行程度之间存在特定的关系。
    To analyze the public opinion related to the employment situation, a combined approach is proposed to study the valuable ideas from social media. Firstly, the popularity of public opinion was analyzed according to the time series from a statistical point of view. Secondly, the feature extraction was carried out on the public opinion information, and the thematic analysis of the employment environment was carried out based on the Latent Dirichlet Allocation model. Thirdly, the Bert model was used to analyze the sentiment classification and trend of the employment-related public opinion data. Finally, the employment public opinion texts in different regions were studied based on the spatial sequence popularity analysis, keyword difference analysis. A case study in China is conducted to verify the effectiveness of proposed combined approach. Results shown that the popularity of employment public opinion reached the highest level in March 2022. Public opinions towards employment situation are negative. There is a specific relationship between the popularity of employment public opinion in different provinces.
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  • 文章类型: Journal Article
    医疗喘息计划(MRP)的特征是一种护理模式,该模式已通过在安全的环境中提供急性后医院护理来满足无家可归者的医疗保健和社会需求。尽管这种模式已被证明可以减少住院,改善健康结果,增加获得卫生服务的机会,之前对MRP方案和结局的研究仅限于个体研究点,可能无法推广到接受MRP治疗的人群.本研究协议描述了一种混合方法设计,以收集组织,提供者,和来自MRP样本的患者水平数据。
    Medical Respite Programs (MRPs) characterize a care model that has been developed to address the health care and social needs of persons experiencing homelessness by providing post-acute hospital care in a safe environment. Although this model has been shown to reduce hospitalizations, improve health outcomes and increase access to health services, prior studies of MRP programs and outcomes have been limited to individual sites and may not generalize to the population of individuals receiving MRP care. This study protocol describes a mixed method design to collect organizational, provider, and patient-level data from a sample of MRPs.
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  • 文章类型: Journal Article
    UNASSIGNED: The present study examined the relationship between addiction and hikikomori (extreme social withdrawal) symptoms.
    UNASSIGNED: A group of clinically referred addiction patients (n = 31) and a group of age- and gender-matched non-clinical controls (n = 34) completed a self-report scale for measuring hikikomori symptoms (the Hikikomori Questionnaire-25) along with some other questionnaires assessing substance use (frequency and severity) and quality of life.
    UNASSIGNED: The results showed that addiction patients displayed significantly higher levels of hikikomori symptoms than the non-clinical control (Cohen\'s d = 3.41); 87.1% even showed such a high score that they were identified as being at risk for the hikikomori syndrome (vs. only 2.9% in the non-clinical control group). Correlational analyses revealed that within the addiction group, the severity of the substance use problem (as quantified by an index of craving) correlated positively with the level of hikikomori symptoms and negatively with quality of life. In other words, the more severe the addiction, the more extreme the social withdrawal tendencies and the lower the quality of life.
    UNASSIGNED: Altogether, the findings provide further support for the marked social impairments of people with substance use problems and underline that this should be an important target of intervention.
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  • 文章类型: Journal Article
    背景:与居住人口相比,经历无家可归(PEH)的人面临更高的不良健康结果和过早死亡的风险,并且在尝试获得医疗服务时经常面临重大障碍。这项研究旨在更好地了解PEH的具体医疗保健需求以及与他们在欧洲背景下及时,公平地获得医疗服务相关的障碍和促进者。
    方法:我们进行了一项探索性的跨国定性研究,涉及奥地利有无家可归生活经验的人以及健康和社会护理专业人员,希腊,西班牙,和英国。共有69位半结构化面试,由15位社会护理专业人员组成,19名医疗保健专业人员,完成了35个PEH,转录,并按主题进行分析。
    结果:研究结果分为与研究问题相关的三个总体主题:(a)PEH的医疗保健需求,(b)获得保健的障碍,(c)获得保健服务的促进者。总的来说,PEH的总体健康状况被描述为非常差,主流卫生服务被描述为没有能力满足这一人口的需求。采用量身定制的护理方法,特别是让值得信赖的专业人员参与提供护理,被确定为克服现有障碍的关键战略。
    结论:这项研究的结果表明,PEH的医疗保健需求以及与他们在不同欧洲环境中获得医疗保健相关的障碍和促进因素具有高度的一致性。无家可归本身被认为是健康的重要社会决定因素,PEH面临获得医疗服务不平等的风险。因此,需要进行更改,以促进PEH获得主流初级保健。这也可以通过对“触达”服务和其他量身定制和以人为中心的医疗保健形式的投资来进一步补充。
    背景:这项研究于2022年6月6日在ClinicalTrials.gov的注册表中进行了回顾性注册,编号为NCT05406687。
    People experiencing homelessness (PEH) are known to be at higher risk of adverse health outcomes and premature mortality when compared to the housed population and often face significant barriers when attempting to access health services. This study aimed to better understand the specific health care needs of PEH and the barriers and facilitators associated with their timely and equitable access to health services in the European context.
    We conducted an exploratory cross-national qualitative study involving people with lived experience of homelessness and health and social care professionals in Austria, Greece, Spain, and the UK. A total of 69 semi-structured interviews comprising 15 social care professionals, 19 health care professionals, and 35 PEH were completed, transcribed, and analysed thematically.
    Findings were organised into three overarching themes relating to the research question: (a) Health care needs of PEH, (b) Barriers to health care access, and (c) Facilitators to health care access. Overall, the general health of PEH was depicted as extremely poor, and mainstream health services were portrayed as ill-equipped to respond to the needs of this population. Adopting tailored approaches to care, especially involving trusted professionals in the delivery of care, was identified as a key strategy for overcoming existing barriers.
    The results of this study indicate there to be a high degree of consistency in the health care needs of PEH and the barriers and facilitators associated with their access to health care across the various European settings. Homelessness in itself is recognized to represent an essential social determinant of health, with PEH at risk of unequal access to health services. Changes are thus required to facilitate PEH\'s access to mainstream primary care. This can also be further complemented by investment in \'in-reach\' services and other tailored and person-centred forms of health care.
    This study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687.
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  • 文章类型: Observational Study
    自杀是一个具有重大经济损失的社会问题,受害者主要来自生产人口。关于自杀风险评估的报告很多,但最注重长期管理。因此,影响急性期身体损伤严重程度和自杀患者预后的因素尚未得到充分研究。这是一项单中心回顾性观察研究。我们收集了急诊科收治的自杀患者的数据。年龄的影响,性别,精神病史,自杀的方法,酒精消费,并对入院后的自杀结局进行评估。使用住院死亡率量表和脑功能类别量表评估28天内住院死亡率的结果。死亡率高的自杀方法(绞刑,跳跃,一氧化碳中毒,和烧伤)被定义为致命方法。对精神分裂症患者进行了详细的预后风险评估,情绪障碍,和躯体形式障碍。我们从计算机化的医疗记录中确定了340名自杀患者,并分析了322条记录,没有丢失数据。非幸存者群体主要由老年人组成,男人,和没有精神病治疗史的患者。相反,在幸存者组中,更多的患者在自杀前饮酒。在亚组分析中,精神分裂症患者的神经系统转归不利.心境障碍患者的住院死亡率比其他精神病患者低,选择致死方法的患者也是如此。根据疾病,与压力相关和躯体形式障碍的患者往往有更高的生存率,尽管他们的精神病住院率较低。相反,心境障碍患者的住院率较高,但生存率较低.结果表明,仅常规门诊治疗可能不足以降低被认为有自杀风险的情绪障碍患者的自杀死亡率。
    Suicide is a social problem with significant economic losses, the victims of which are mainly from the productive population. There are numerous reports on the assessment of suicide risk, but most focus on long-term management. Therefore, factors influencing the severity of physical impairments in the acute phase and the prognosis of suicidal patients have not been sufficiently investigated. This is a single-center retrospective observational study. We collected data on suicidal patients admitted to our emergency department. The effect of age, gender, psychiatric history, method of suicide, alcohol consumption, and hospital admission on the outcome of suicide was assessed. Outcomes were assessed using the hospital mortality scale and the cerebral performance category scale for in-hospital mortality within 28 days. Methods of suicide with a high mortality rate (hanging, jumping, carbon monoxide poisoning, and burns) were defined as lethal methods. A detailed risk assessment of outcomes was performed for patients with schizophrenia, mood disorders, and somatoform disorders. We identified 340 suicide patients from computerized medical records and analyzed 322 records without missing data. The non-survivor group predominantly comprised older adults, men, and patients without a history of psychiatric treatment. Contrastingly, more patients drank alcohol before suicide in the survivor group. In the subgroup analysis, patients with schizophrenia had unfavorable neurological outcomes. Patients with mood disorders had worse in-hospital mortality than other psychiatric patients, as did patients who chose the lethal method. By disease, patients with stress-related and somatoform disorders tended to have higher survival rates, although their psychiatric hospitalization rates were lower. Conversely, patients with mood disorders had a higher rate of hospital visits but a lower survival rate. The results suggest that usual outpatient treatment alone may not be sufficient to reduce suicide mortality in patients with mood disorders who are considered to be at high risk of suicide.
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  • 文章类型: Journal Article
    研究青少年孤独与心理社会适应之间的联系缺乏全面的,以人为中心的孤独和社交能力的差异模式的检查。目前的研究调查了1071名青少年(Mage=12.48,SD=1.71,49.86%女性,年龄范围=10-16岁)。使用潜在剖面分析,确定了四组具有不同的孤独特征模式(即,享受,动机,preference,频率)和社交能力。结果表明,在各个时间点,较差的心理社会适应与PFS-NonSociable组的成员资格相关(特征为高享乐,preference,和孤独的频率;低社交能力)与所有其他群体相比。研究结果表明,只有在缺乏社交能力的情况下,青少年的孤独似乎与更糟糕的社会心理适应有关。
    Research examining the link between solitude and psychosocial adjustment among adolescents has lacked a comprehensive, person-centered examination of differential patterns of both solitude and sociability. The current study surveyed 1071 adolescents (Mage = 12.48, SD = 1.71, 49.86% female, age range = 10-16 years). Using latent-profile analysis, four groups were identified with differential patterns of characteristics of solitude (i.e., enjoyment, motivations, preference, frequency) and sociability. Results indicated that worse psychosocial adjustment across time points was associated with membership in the PFS-NonSociable group (characterized by high enjoyment, preference, and frequency of solitude; low sociability) compared to all other groups. Findings suggest that solitude for adolescents appears to be linked to worse psychosocial adjustment only if accompanied by a lack of sociability.
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  • 文章类型: Journal Article
    背景:那些经历无家可归的人有巨大的健康和口腔健康需求,并且处于健康不平等的极端状态。该研究的目的是对伦敦无家可归者进行口腔健康需求评估,并对其口腔健康相关生活质量产生影响。
    方法:口腔健康需求评估包括定量和定性方法。这包括一份调查问卷,以评估感知的口腔健康需求,与口腔健康相关的生活质量。此外,由13名同行倡导者组成的焦点小组.
    结果:焦点小组的研究结果表明,无家可归的人群在保持良好的口腔健康和获得包括精神病在内的牙科护理方面面临着许多挑战。污名,成本,和混乱的生活方式。问卷调查的应答率为79%(n=315)。结果显示高水平的未满足的牙科需求和危险的健康行为,包括60%的吸烟者,39%的人每天消耗大量的糖,52.4%的人每天刷牙不到两次。超过三分之一(32.1%)经历过牙痛。大多数受访者(n=224)非常或相当关注他们的牙齿健康。感知的口腔健康状况与口腔健康相关的生活质量之间存在显着关联。
    结论:在伦敦经历无家可归的人被发现有高水平的口腔健康需求未得到满足,这显著影响了他们口腔健康相关的生活质量。仅关注改变行为是不够的,因此解决无家可归的结构性决定因素对于改善这一弱势群体的口腔和健康结果至关重要。
    Those experiencing homelessness have significant health and oral health needs and are at the extreme of health inequalities. The aim of the study was to conduct an oral health needs assessment for those experiencing homeless in London and impacts on their oral health-related quality of life.
    The oral health needs assessment consisted of quantitative and qualitative methods. This included a survey questionnaire to assess perceived oral health needs, and oral health related quality of life. In addition, a focus group was conducted with 13 peer advocates.
    Findings from the focus group revealed numerous challenges for homeless populations to maintain good oral health and access to dental care including mental ill-health, stigma, costs, and chaotic lifestyles. A response rate of 79% (n = 315) was achieved for the questionnaire survey. Results showed high levels of unmet dental needs and risky health behaviours including 60% reporting being smokers, 39% consuming high amounts of sugar and 52.4% brushing their teeth less than twice a day. More than a third (32.1%) had experienced toothache. The majority of respondents 80% (n = 224) were very or fairly concerned about their dental health. There were significant associations between perceived oral health status and oral health-related quality of life.
    Those experiencing homelessness in London were found to have high levels of unmet oral health needs, which significantly impacted on their oral health-related quality of life. Focusing on changing behaviours alone is insufficient and therefore addressing the structural determinants of homelessness is vital in improving oral and health outcomes of this vulnerable population.
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