Preventive Health Services

预防性卫生服务
  • 文章类型: Journal Article
    个人对预防保健服务的使用不足或过度使用是其对疾病风险态度的外在行为反映,他们受到信息获取能力的强烈影响。因此,我们试图探索公众风险偏好之间的关系,信息获取能力以及预防性卫生服务的使用不足或过度使用,为信息时代的决策提供依据。该调查于2019年9月至12月对中国2,211名年龄≥18岁的受访者进行了调查。以癌症筛查为例,采用多重价格表(MPL)检验和项目反应理论(IRT)模型来衡量个体风险偏好和信息获取能力。采用Logit模型和Tobit模型对风险偏好之间的关系进行了估计,信息获取能力以及预防性卫生服务的使用不足或过度使用。寻求风险的人更有可能充分利用预防性卫生服务,而厌恶风险的个人更有可能过度使用此类服务。信息获取能力可能会改善寻求风险的个人对预防性卫生服务的未充分利用,但会加剧规避风险的个人对预防性卫生服务的过度使用。在被调查的信息渠道中,互联网是公众获取信息最有效的途径。有必要改变公众对疾病风险和与预防性卫生服务相关的风险的错误认识。在飞速发展的信息时代,提高公共信息获取能力是纠正风险偏好与个人对预防性卫生服务的未充分利用或过度使用之间的负相关的可行方法。
    The underuse or overuse of preventive health services by individuals is an outward behavioural reflection of their attitude towards disease risk, and they are strongly influenced by their information-acquisition ability. Therefore, we try to explore the relationship among the public risk preference, information-acquisition ability and underuse or overuse of preventive health services, in order to provide decision-making basis in the Information Age. The survey surveyed 2,211 respondents aged ≥ 18 in China from September to December 2019. Taking cancer screening as an example, the multiple price list (MPL) test and item response theory (IRT) model were used to measure individual risk preference and information-acquisition ability. The Logit model and Tobit model were used to estimate the relationship between risk preference, information-acquisition ability and underuse or overuse of preventive health services. Risk-seeking individuals were more likely to underuse preventive health services, while risk-averse individuals were more likely to overuse such services. Information-acquisition ability may improve the underuse of preventive health services in risk-seeking individuals but exacerbate the overuse of preventive health services in risk-averse individuals. Among the investigated information channels, the Internet is the most effective way for the public to obtain information. It is necessary to change the public\'s incorrect perception of disease risks and risks associated with preventive health services. In the rapid development of the Information Age, improving public information-acquisition ability is a practicable way to correct the negative relationship between risk preference and individuals\' underuse or overuse of preventive health services.
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  • 文章类型: Journal Article
    背景:生活中的意义在刺激健康和预防行为方面可能具有临床意义。该研究旨在调查中国成年人的生活意义与预防性医疗保健使用之间的关系,并评估他们在协会中的年龄和性别差异。
    方法:于2020年2月对中国1444名18-64岁成年人进行了横断面在线调查。采用Logistic回归模型来检查生命意义与预防性健康检查的关系,并评估其年龄和性别差异。
    结果:生活意义的平均得分为5.801(标准差=1.349),共7分。在调整社会人口统计学因素后,生活意义水平的每个单位增加与使用预防性健康检查(任何类型)的可能性增加12.2%(调整后的优势比1.122,95%置信区间1.015-1.241)相关,合并症和其他心理健康因素。生活中的意义与X射线的使用显着相关(1.125,1.010-1.253),B超(1.176,1.058-1.306),和血液检测(1.152,1.042-1.274)。生活中的意义与这些类型的预防保健之间的关联随着年龄的增长而增加,但是在这些关联中没有性别差异。
    结论:更高的生命意义与更多的预防性健康检查独立相关。加强健康教育和干预措施以改善生活意义的策略可能是增加中国预防性医疗保健使用的重要组成部分。
    Meaning in life could be of clinical importance in stimulating healthy and preventive behaviors. The study aimed to investigate the association between meaning in life and preventive healthcare use among Chinese adults, and to assess their age and gender differences in the association.
    A cross-sectional online survey was conducted among 1444 adults aged 18-64 years in February 2020 in China. Logistic regression models were employed to examine the association of meaning in life with preventive health checkups and assess their age and gender differences.
    The mean score of meaning in life was 5.801 (Standard Deviation = 1.349) out of 7. Each unit increase on the level of meaning in life was associated with 12.2% higher likelihood of using preventive health checkups (any type) (adjusted odds ratio 1.122, 95% confidence interval 1.015-1.241) after adjustment for sociodemographic factors, comorbidity and other psychological health factors. Meaning in life was significantly associated with the uses of X-ray (1.125, 1.010-1.253), B-ultrasound (1.176, 1.058-1.306), and blood testing (1.152, 1.042-1.274). The associations between meaning in life and these types of preventive healthcare increased with age, but there were no gender differences in these associations.
    Higher meaning in life was independently related to more preventive health checkups. Strategies to strengthen health education and interventions to improve experience of meaning in life might be an important component to increase preventive healthcare use in China.
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  • 文章类型: Journal Article
    目的:筛查肝细胞癌(HCC)作为减轻晚期诊断负担的有效手段,在中国仍未得到充分利用。许多亚洲国家,从某种意义上说,全世界。应确定可改变的社会心理因素,以提高筛查利用率并减轻晚期诊断的负担。然而,有效的社会心理措施是不可用的。本研究旨在翻译,文化适应,并验证了用于测量乙型肝炎患者HCC筛查的社会心理因素的预防健康模型(PHM)工具。
    方法:本研究于2020年6月至2021年4月进行了三个严格的阶段:(1)基于委员会的英译汉;(2)认知访谈(n=33)和德尔福专家咨询(n=7)的文化适应;(3)横断面研究(n=305)。
    结果:在第一阶段,两个项目被重新措辞,和两个重新翻译的语义对等。在第二阶段,与理解有关的问题,敏感的措辞,措辞清晰,问题相关性,文化敏感性通过包括图片来解决,重新措辞五个项目,开发七个项目。在第三阶段,探索性和验证性因素分析提出了一个五因素20项解决方案:它解释了76.9%的方差;有足够的因素负荷(.60-.91),收敛效度和判别效度;令人满意的模型拟合指数;和可靠性(Cronbach'sα,.86-.91)。已知组分析表明,具有最佳HCC筛查行为的患者在每个子量表上的得分明显高于没有这样的患者。
    结论:中国PHM仪器具有文化敏感性,可靠,并有效地测量HCC筛查的心理社会因素。它可以帮助护士和研究人员定制策略,以改善高风险HCC地区的临床HCC筛查实践。
    OBJECTIVE: Screening for hepatocellular carcinoma (HCC) as an effective instrument to reduce the burden of late diagnoses remains underutilized in China, much of the Asian countries, and in a sense all over the world. Modifiable psychosocial factors should be identified to improve screening utilization and reduce the burden of late diagnoses. However, valid psychosocial measures are unavailable. This study aimed to translate, culturally adapt, and validate the preventive health model (PHM) instrument for measuring psychosocial factors of HCC screening among patients with hepatitis B.
    METHODS: This study was conducted from June 2020 to April 2021 in three rigorous phases: (1) committee-based translation from English to Chinese; (2) cognitive interviews (n = 33) and Delphi expert consultations (n = 7) for cultural adaptation; and (3) a cross-sectional study (n = 305) for validation.
    RESULTS: In phase I, two items were reworded, and two retranslated for semantic equivalence. In phase II, issues related to comprehension, sensitive wording, wording clarity, question relevance, and cultural sensitivity were addressed by including pictures, rewording five items, and developing seven items. In phase III, exploratory and confirmatory factor analyses suggested a five-factor 20-item solution: it explained 76.9% of the variance; had adequate factor loading (.60-.91), convergent and discriminant validity; satisfactory model fit indices; and reliability (Cronbach\'s α, .86-.91). Known-group analysis showed that patients with optimal HCC screening behavior had significantly higher scores on each subscale than those not having such.
    CONCLUSIONS: The Chinese PHM instrument is culturally sensitive, reliable, and valid to measure the psychosocial factors of HCC screening. It can help nurses and researchers to tailor strategies to improve clinical HCC screening practices in high-risk HCC regions.
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  • 文章类型: Journal Article
    COVID-19期间的预防性健康行为不仅保护了自己,也保护了他人的福利。然而,很少关注青少年的亲社会动机,他们经常被视为自私和自我中心。因此,本研究旨在利用纵向数据探讨移情在青少年预防健康行为中的作用。
    在大流行期间,共有442名中国青少年(青年平均年龄=13.35岁;49.5%的女孩和50.5%的男孩)在两个月内完成了两波纵向调查(时间1:2020年7月;时间2:2020年9月)。在T1,参与者报告了他们的共情关注,透视,以及对个人健康的关注。在T1和T2时,参与者报告了他们的预防性健康行为和与COVID相关的担忧。
    随着时间的推移,表现出更大的共情关注的青少年倾向于采取更多的预防性健康行为(p<.01)。然而,随着时间的推移,更大的共情关注也预示着青少年对COVID-19的更大担忧(p<0.01)。相比之下,青少年对个人健康的看法和关注并不能预测他们随着时间的推移的健康行为或担忧。值得注意的是,在考虑到青少年对个人健康的观点和关注后,共情关注对预防性健康行为和COVID相关担忧的纵向影响仍然存在(ps<.05)。
    这些发现强调了青少年在大流行期间从事预防性健康行为的亲社会动机,并指出了移情关注对青少年心理健康的潜在负面影响。
    Preventive health behavior during COVID-19 protects not only oneself but also the welfare of others. However, little attention has been paid to prosocial motivation in adolescents, who are often viewed as selfish and egocentric. Therefore, the current study aimed to explore the role of empathy in adolescents\' preventive health behavior using longitudinal data.
    A total of 442 Chinese adolescents (mean age of youth = 13.35 years; 49.5% girls and 50.5% boys) completed two-wave longitudinal surveys over the span of two months during the pandemic (Time 1: July 2020; Time 2: September 2020). At T1, participants reported on their empathic concern, perspective taking, and concern for personal health. At both T1 and T2, participants reported on their preventive health behavior and COVID-related worry.
    Adolescents who showed greater empathic concern tend to engage in more preventive health behavior over time (p < .01). However, greater empathic concern also predicted adolescents\' greater worry about COVID-19 over time (p < .01). In comparison, adolescents\' perspective-taking and concern for personal health did not predict their health behavior or worry over time. Notably, the longitudinal effect of empathic concern on preventive health behavior and COVID-related worry remained (ps < .05) after taking into account adolescents\' perspective-taking and concern for personal health.
    These findings highlight adolescents\' prosocial motivation in engaging in preventive health behavior during the pandemic and also point out the potential negative influence of empathic concern on adolescent mental health.
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  • 文章类型: Journal Article
    背景:妊娠糖尿病(GDM)是影响数百万孕妇的全球性问题,包括在中国大陆。这些女性患II型糖尿病(T2DM)的风险很高。需要具有成本效益和临床有效的干预措施。我们旨在探讨中国女性的观点,关注和动机参与早期产后干预和/或研究,以防止在受GDM影响的妊娠后发生T2DM。
    方法:我们在成都的两家医院进行了一项定性研究,中国西南地区。对20名最近有GDM经历的妇女进行了面对面的半结构化访谈:16名产后妇女和4名孕妇。女性被问及她们对产后筛查2型糖尿病的态度,生活方式干预,mHealth提供了干预措施和药物干预措施(特别是二甲双胍)。采用归纳法进行分析。采访被记录下来,转录,并使用NVivo12Pro进行编码。
    结果:大多数女性对参加T2DM筛查持积极态度,并愿意参与产后干预,通过改变生活方式或m健康干预来预防2型糖尿病。女性不太可能同意药物干预,除非他们的家庭成员患有糖尿病或在怀孕期间需要药物治疗。我们确定了影响妇女对未来干预措施态度的七个领域:(1)怀孕期间与卫生系统的经验;(2)生活在有利的环境中;(3)家庭成员的T2DM经验;(4)糖尿病知识和对风险的感知;(5)对个人和婴儿健康的关注;(6)感觉和情绪,(7)生活方式的限制。那些患有更严重GDM的人,有利的环境和健康知识,并有T2DM经验的家庭成员对产后干预和研究参与预防GDM后T2DM表示更积极的看法。那些认为自己患有轻度GDM的人和那些有时间/生活方式限制的人不太可能参与。
    结论:成都有GDM经历的女性一般愿意参与早期产后干预和/或研究,以降低她们患T2DM的风险。偏爱非药物,基于mHealth的干预措施,整合生活方式改变策略,血糖监测,产后恢复和心理健康。
    妊娠糖尿病(GDM)是一种常见的妊娠并发症,在全球范围内影响多达六分之一的孕妇。虽然情况通常在交货后很快解决,女性患2型糖尿病(T2DM)的风险较高.在这项研究中,我们询问住在成都的妇女,中国西部的一座城市,了解他们对糖尿病风险的了解,以及他们在出生后参与干预措施以预防T2DM的感受。在听取了20位女性的意见后,我们得出的结论是,在这种情况下,大多数女性在出生后都乐于参加T2DM筛查计划,并愿意考虑在出生后参与干预和研究以预防T2DM。最优选的干预措施是那些旨在改变生活方式的干预措施,许多女性表示希望通过智能手机接收这些信息,例如通过应用程序或社交媒体渠道。妇女不愿服用药物来预防T2DM。影响妇女对预防2型糖尿病的干预措施的主要因素是:(1)她们在怀孕期间与卫生系统的经历;(2)家庭环境是否支持改变饮食和生活方式;(3)家庭成员中是否有2型糖尿病的经历;(4)他们对糖尿病的了解和对风险的看法;(5)对个人和婴儿健康的担忧;(6)产后的感受和情绪。和(7)生活方式的限制,使饮食的改变变得困难。
    BACKGROUND: Gestational diabetes (GDM) is a global problem affecting millions of pregnant women, including in mainland China. These women are at high risk of Type II diabetes (T2DM). Cost-effective and clinically effective interventions are needed. We aimed to explore Chinese women\'s perspectives, concerns and motivations towards participation in early postpartum interventions and/or research to prevent the development of T2DM after a GDM-affected pregnancy.
    METHODS: We conducted a qualitative study in two hospitals in Chengdu, Southwest China. Face-to-face semi-structured interviews were conducted with 20 women with recent experience of GDM: 16 postpartum women and 4 pregnant women. Women were asked about their attitudes towards postpartum screening for type 2 diabetes, lifestyle interventions, mHealth delivered interventions and pharmacologic interventions (specifically metformin). An inductive approach to analysis was used. Interviews were recorded, transcribed, and coded using NVivo 12 Pro.
    RESULTS: Most women held positive attitudes towards participating in T2DM screening, and were willing to participate in postpartum interventions to prevent T2DM through lifestyle change or mHealth interventions. Women were less likely to agree to pharmacological intervention, unless they had family members with diabetes or needed medication themselves during pregnancy. We identified seven domains influencing women\'s attitudes towards future interventions: (1) experiences with the health system during pregnancy; (2) living in an enabling environment; (3) the experience of T2DM in family members; (4) knowledge of diabetes and perception of risk; (5) concerns about personal and baby health; (6) feelings and emotions, and (7) lifestyle constraints. Those with more severe GDM, an enabling environment and health knowledge, and with experience of T2DM in family members expressed more favourable views of postpartum interventions and research participation to prevent T2DM after GDM. Those who perceived themselves as having mild GDM and those with time/lifestyle constraints were less likely to participate.
    CONCLUSIONS: Women with experiences of GDM in Chengdu are generally willing to participate in early postpartum interventions and/or research to reduce their risk of T2DM, with a preference for non-drug, mHealth based interventions, integrating lifestyle change strategies, blood glucose monitoring, postpartum recovery and mental health.
    Gestational diabetes mellitus (GDM) is a common pregnancy complication affecting up to 1 in 6 pregnant women worldwide. Whilst the condition usually resolves soon after delivery, women are at high risk of developing type 2 diabetes mellitus (T2DM). In this study, we asked women living in Chengdu, a city in western China, about what they knew about their risk of diabetes and how they felt about participating in interventions after birth to prevent T2DM.After listening to the views of 20 women, we concluded that in this setting most women are happy to attend T2DM screening programs after birth, and would be willing to consider participating in interventions and research after birth to prevent T2DM.The interventions most preferred were those that aimed at lifestyle changes, and many women said would like to receive this information through their smartphone, for example through an app or social media channel. Women were reluctant to take medications to prevent T2DM.The main factors that influenced how women felt towards interventions to prevent T2DM were: (1) their experiences with the health system during pregnancy; (2) whether the home environment was supportive to make changes to diet and lifestyle; (3) any experiences of T2DM in family members; (4) their knowledge of diabetes and perception of risk; (5) concerns about personal and baby health; (6) feelings and emotions in the postnatal period, and (7) lifestyle constraints making it difficult to make dietary changes.
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  • 文章类型: Journal Article
    教育机构及时实施了一系列措施,以防止COVID-19在国际中国学生中传播,比如限制性体育锻炼,戴口罩,每日健康报告,等。这种行为改变运动的成功很大程度上取决于意识的建立,对当局的满意和信任。本研究的目的是评估预防性,在COVID-19大流行期间为在中国的国际学生采取的支持性和提高认识措施,这将有助于在世界其他地区潜在的大流行情况下规划这种行为改变运动。
    我们通过微信对467名在华留学生进行了在线电子问卷调查。数据收集时间为2020年2月20日至2020年3月10日,我们关注他们的意识水平,满意,以及对当局在大流行措施方面的信任。使用简单的双变量统计数据来描述受访者的背景特征,并采用偏最小二乘结构方程模型(PLS-SEM)作为最终模型来证明变量之间的关系。
    在我们的研究中,受访者的领导小组在31至35岁年龄段(39.82%),男性(61.88%),单身(58.24%)和博士生(39.8%)。学生采取的和/或由相应机构或当局提供的预防和支持措施与学生的满意度呈正相关,并且具有可接受的强度(β=0.611,t=9.679,p<0.001)。当局获得的信任也显示出可接受的强度(β=0.381,t=5.653,p<0.001),方向为正。再一次,在当局中,与学生满意度(β=0.295,t=2.719,p<0.001)和信任获得(β=0.131,t=1.986,p<0.05)相关的人员意识建设具有积极和可接受的强度。因此,我们的研究清楚地表明了预防和支持措施对学生满意度发展的巨大影响(R2=0.507,表明中度关系).满意的学生具有强大的影响力,最终有助于在他们的机构上建立足够的信任(R2=0.797,表明上述实质性关系)。
    在这种情况下,全球学生群体是受影响最严重和最脆弱的社区之一。所以,对于不同的州或当局如何处理这种情况,有深刻的研究基础。在这项研究中,我们描述了中国政府和教育机构为缓解疫情恐慌而对国际学生采取的照顾的类型和程度。应采取进一步的研究和此类举措,以考虑未来的新情况。
    Education institutions promptly implemented a set of steps to prevent the spread of COVID-19 among international Chinese students, such as restrictive physical exercise, mask wear, daily health reporting, etc. Success of such behavioral change campaigns largely depends on awareness building, satisfaction and trust on the authorities. The purpose of this current study is to assess the preventive, supportive and awareness-building steps taken during the COVID-19 pandemic for international students in China, that will be useful for planning such a behavioral change campaign in the potential pandemic situation in other parts of the world.
    We conducted an online-based e-questionnaire survey among 467 international students in China through WeChat. The data collection duration was from February 20, 2020 to March 10, 2020 and we focused on their level of awareness, satisfaction, and trust in authorities regarding pandemic measures. Simple bivariate statistics was used to describe the background characteristics of the respondents along with adoption of the partial least squares-structural equation modeling (PLS-SEM) as the final model to demonstrate the relationship between the variables.
    In our study, the leading group of the respondents were within 31 to 35 years\' age group (39.82%), male (61.88%), living single (58.24%) and doctoral level students (39.8%). The preventive and supportive measures taken by students and/or provided by the respective institution or authorities were positively related to students\' satisfaction and had an acceptable strength (β = 0.611, t = 9.679, p < 0.001). The trust gained in authorities also showed an acceptable strength (β = 0.381, t = 5.653, p < 0.001) with a positive direction. Again, the personnel awareness building related to both students\' satisfaction (β = 0.295, t = 2.719, p < 0.001) and trust gain (β = 0.131, t = 1.986, p < 0.05) in authorities had a positive and acceptable intensity. Therefore, our study clearly demonstrates the great impact of preventive and supportive measures in the development of students\' satisfaction (R2 = 0.507 indicating moderate relationship). The satisfied students possessed a strong influence which eventually helped in building sufficient trust on their institutions (R2 = 0.797 indicating above substantial relationship).
    The worldwide student group is one of the most affected and vulnerable communities in this situation. So, there is a profound ground of research on how different states or authorities handle such situation. In this study, we have depicted the types and magnitude of care taken by Chinese government and educational institutions towards international students to relieve the panic of pandemic situation. Further research and such initiatives should be taken in to consideration for future emerging conditions.
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  • 文章类型: Journal Article
    BACKGROUND: Preventive health checkups have gained in importance over the last decade. The association of health checkups and the number of diseases with health-related quality of life (HRQoL), including physical and mental health, remains unclear. We sought to investigate the aforementioned association among Taiwanese public servants.
    METHODS: A cross-sectional survey was conducted using randomized and multistage stratified cluster sampling based on proportional probabilistic sampling. The questionnaires addressed demographics, job characteristics, health behaviors, health status, 3 types of health checkups during the preceding 3 years (government-paid health checkup [GPHC], self-paid health checkup [SPHC], and no health checkup [NOHC]), and physical component summary (PCS) and mental component summary (MCS) scores of the Short-Form Health Survey. In total 11,454 middle-aged public servants were analyzed. A multivariate general linear model (GLM) was used to estimate PCS and MCS scores by using least square means.
    RESULTS: Health checkup types were associated with a significant difference in PCS scores among the public servants. Scores of PCS and MCS were both significantly higher in the GPHC group than in the NOHC group for those with no chronic diseases (51.20 vs. 50.66 [P = 0.008] and 46.23 vs. 45.58 [P = 0.02], respectively). Compared with the NOHC group, both scores of GPHC and SPHC groups were significantly associated with higher PCS scores for public servants with ≥ 2 chronic diseases (46.93 vs. 45.13 [P = 0.002] and 46.52 vs. 45.13 [P = 0.009], respectively).
    CONCLUSIONS: In Taiwan, public servants undergoing GPHCs are more likely to report higher PCS scores than are those undergoing SPHCs. It is crucial that encourage periodically using the health checkup to improve health status and HRQoL.
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  • 文章类型: Journal Article
    UNASSIGNED: Alcohol consumption is a risk factor for stroke. However, there are no available data on the effect of alcohol consumption on the long-term outcome of ischemic stroke in China. Therefore, this study aimed to explore the association of alcohol consumption with the prognosis of ischemic stroke by subtype in different follow-up periods after stroke.
    UNASSIGNED: This 12-month follow-up study recruited 3830 acute ischemic stroke patients from Tianjin, China, between 2016 and 2018. Patients were categorized into two groups according to their consumption of alcohol. Differences in mortality, recurrence, and dependency rates at 3 and 12 months after stroke were compared between both groups.
    UNASSIGNED: The mortality, recurrence, and dependency rates at 12 months after stroke were significantly higher in patients who previously consumed alcohol than in those without previous alcohol consumption (all P < 0.005). A similar trend was observed for mortality rate at 3 months after stroke (P < 0.001). The risk of death at 3 months after an atherothrombotic stroke decreased by 63.4% (relative risk [RR], 0.366; 95% confidence interval [CI], 0.144-0.935) among patients who previously consumed alcohol compared with those who never consumed alcohol. Moreover, for patients with small artery disease classified according to the Trial of ORG 10,172 in Acute Stroke Treatment (TOAST), the recurrence and dependency rates at 12 months after stroke decreased by 49.2% (RR, 0.508; 95% CI, 0.259-0.996) and 49.5% (RR, 0.505; 95% CI, 0.258-0.990), respectively, among patients who consumed alcohol.
    UNASSIGNED: Previous alcohol consumption decreased the risk of death at 3 months after stroke among patients with atherothrombotic stroke according to the TOAST classification. Furthermore, for patients with small artery disease (according to TOAST classification), alcohol consumption significantly decreased the risk of recurrence and dependency at 12 months after stroke. This study highlights an urgent need to quantify the association of alcohol consumption with outcomes after stroke in China to improve stroke prognosis.
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  • 文章类型: Comparative Study
    背景:有组织的乳腺癌和宫颈癌筛查计划只能为中国和其他资源匮乏国家的一小部分社会经济贫困妇女免费提供服务,然而,几乎没有证据表明这一方案是否有效影响人口一级的参与和不平等。
    方法:我们使用了2014-2015年全国横断面调查的个人水平数据,用于参与乳腺癌和宫颈癌筛查。干预和比较分组的数据为2009年至2014年国家乳腺癌和宫颈癌筛查计划,该计划涵盖的县被分为干预组。我们用两种方法评估了干预对参与率和不平等程度的影响:多变量多水平逻辑回归,调整个体和地区水平的协变量;差异分析结合倾向评分匹配,估计平均干预效果。
    结果:69,875名包括35-64岁的女性,21,620人分为干预组,43,669人分为比较组进行乳腺癌筛查;31,794人分为干预组,33,682人进入对照组进行宫颈癌筛查。干预组乳腺癌筛查参与率高于对照组(25.3,95%保密区间[CI],22.8%-27.7%,vs19.1,17.4-20.7%),和宫颈癌筛查(25.7%,23.8%-27.7%,vs21.5,19.6-23.5%),分别。干预显着增加了整体女性参与乳腺癌和宫颈癌筛查的可能性,农村妇女和城市妇女,而农村妇女的影响明显高于城市妇女。乳腺癌筛查对参与率的平均干预效果为增加7.5%(6.7-8.2%),宫颈癌筛查占6.8%(6.1-7.5%),分别。农村和城市之间的不平等显著减少了37-41%(P<0.001),然而,在年龄方面略有减少甚至增加,教育状况,和家庭收入。
    结论:针对一小部分女性的有组织的乳腺癌和宫颈癌筛查计划可以提高人口水平的参与率。然而,它不会显著影响社会经济引入的不平等。需要进一步的研究进行时间序列分析并加强因果相关性。
    BACKGROUND: Organized breast and cervical cancer screening programme could only provide services at no cost for a fraction of socioeconomic-deprived women in China and other low-resource countries, however, little evidence exists for whether such a programme effectively affect the participation and inequalities at the population level.
    METHODS: We used individual-level data from a nationally cross-sectional survey in 2014-2015 for breast and cervical cancer screening participation. Data for intervention and comparison grouping were from 2009 to 2014 national breast and cervical cancer screening programme, and counties covered by the programme were divided into intervention group. We assessed the impact of the intervention on the participation rates and the magnitude of inequalities with two approaches: multivariable multilevel logistic regressions adjusting for individual- and region-level covariates; and a difference analysis combined with propensity score matching that estimated the average intervention effect.
    RESULTS: Of 69,875 included women aged 35-64 years, 21,620 were classified into the intervention group and 43,669 into the comparison group for breast cancer screening; and 31,794 into the intervention group, and 33,682 into the comparison group for cervical cancer screening. Participation rate was higher in intervention group than comparison group for breast cancer screening (25.3, 95% confidential interval [CI], 22.8-27.7%, vs 19.1, 17.4-20.7%), and cervical cancer screening (25.7, 23.8-27.7%, vs 21.5, 19.6-23.5%), respectively. Intervention significantly increased the likelihood of participation for both breast cancer and cervical cancer screening in overall women, rural women and urban women, whereas the effect was significantly higher in rural women than urban women. The average intervention effect on the participation rate was an increase of 7.5% (6.7-8.2%) for breast cancer screening, and 6.8% (6.1-7.5%) for cervical cancer screening, respectively. The inequalities were significantly decreased by 37-41% (P < 0.001) between rural and urban, however, were slightly decreased or even increased in terms of age, education status, and household income.
    CONCLUSIONS: Organized breast and cervical cancer screening programme targeting for a fraction of women could increase the participation rates at population level, however, it could not significantly affect socioeconomic-introduced inequalities. Further studies are need to conduct time-series analyses and strengthen the causal correlation.
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  • 文章类型: Journal Article
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