ObjectiveThis observational study examined the risk factors associated with recurrence in patients with mild ischemic stroke and determined the characteristics of high-risk groups.MethodsA total of 656 patients hospitalized for mild ischemic stroke were monitored for 1 year. Statistical analyses, including odds ratio calculations and K-means clustering, were conducted to examine risk factors for recurrence and the characteristics of high-risk groups.ResultsAfter 1 year of follow-up, 99 patients experienced recurrent mild ischemic stroke, resulting in a recurrence rate of 15.09%. The analysis revealed several significant risk factors, including type 2 diabetes mellitus, atrial fibrillation, smoking and alcohol consumption, carotid artery stenosis, cerebral vascular stenosis, and multiple lesions. Propensity score matching confirmed these associations, and K-means clustering revealed that older males with type 2 diabetes mellitus and hypertension were likely to be in the high-risk group.ConclusionsHealthcare professionals should focus on tailored treatment and prevention strategies for high-risk patients, prioritizing the management of the abovementioned risk factors to reduce recurrence and improve outcomes.

OBJECTIVES:To examine the association between friendly community environments and depressive symptoms among older adults in China and to investigate the potential mediating roles of happiness and confidence in this association. DESIGN:A nationally representative longitudinal study employing the parallel mediation model to estimate the direct association. Bootstrapping procedures were employed to test the hypothesised mediating effects. SETTING:The China Family Panel Studies (CFPS) database, a nationally representative survey. PARTICIPANTS:The analytical sample comprised 3182 individuals aged 60 years or older from the CFPS 2016, 2018 and 2020 waves. OUTCOME MEASURES:Depressive symptoms were measured using an eight-item version of the Center for Epidemiologic Studies Depression Scale. Higher scores indicated more depressive symptoms. Friendly community environment, happiness and confidence were assessed using corresponding survey items. RESULTS:The analysis revealed a significant direct negative association was observed between friendly community environments and depressive symptoms (β=-0.062, 95% CI -0.092 to -0.035, p<0.001). This effect was significantly mediated by increased happiness (indirect effect=-0.025, 95% CI -0.036 to -0.017, p<0.001) and increased confidence (indirect effect=-0.036, 95% CI -0.048 to -0.026, p<0.001). The urban-rural heterogeneity analysis demonstrates that the research findings remain robust across both urban and rural subsamples. CONCLUSION:Friendly community environments are negatively associated with depressive symptoms among older adults in China, primarily by enhancing happiness and confidence in life. To promote healthy ageing, it is crucial to create comfortable, clean and convenient community environments tailored to the older adult population.

Introduction A notable deficiency lies in the absence of tailored instruments for comprehensively evaluating the health literacy of middle-aged and elderly residents in rural areas of China. Given the context of China’s ageing demographic and the increasing urban–rural disparities, it becomes imperative to formulate a dedicated assessment tool for appraising the health literacy of rural middle-aged and elderly populations. Methods A systematic and rigorously structured development approach was used. First, the concept of health literacy was used to create a pool of items. Second, the Delphi method was used to revise and finalise the initial version of the Chinese Rural Middle-aged and Elderly Health Literacy Scale (CREHLS). Third, pretesting was used to assess the rationality of the item settings within the CREHLS. Finally, a large-sample survey was used to assess the reliability and validity of the finalisation CREHLS. Results The CREHLS, which comprises 26 items distributed across four dimensions, is designed to evaluate the capacity to access, comprehend, assess and apply pertinent health information related to disease treatment, disease prevention, health promotion and environmental health. Multiple test results affirm the robust reliability and validity of the CREHLS, adhering to the established development standards. Conclusions This study expects that the CREHLS will be validated in different rural regions of China and will be a reference for assessing the health literacy of rural middle-aged and elderly people in other countries, thereby increasing our attention to the health literacy of rural people.

Research on the connection between altitude and depression in China remains scarce, despite the country's extensive plateau regions. While the impact of altitude on physical health is well documented, existing studies have largely focused on social adaptation or physical well-being, leaving the relationship between altitude and depression underexplored. This study addresses this gap by examining how altitude affects depression among Chinese residents. Data were drawn from various sources, including the 2016 similar to 2020 China Family Panel Studies, the 2015 China Health and Retirement Longitudinal Study, the 2016 survey on physical and mental health in Yushu, and statistics from the China Urban Statistical Yearbook and China Statistical Yearbook. The study involved the use of several statistical techniques, including multilevel linear models, mediation models, and epidemiological case-control methods. The results revealed a significant positive association between altitude and depression, even when personal factors such as age, sex, education, and chronic illness were controlled for, along with regional factors such as temperature, PM 2.5 concentration, per capita GDP, and hospital bed availability. Notably, per capita GDP and C-reactive protein levels were found to mediate this relationship. The risk of depression in individuals living at altitudes of 500 similar to 1 000 metres, 1 000 similar to 2 000 metres, and 4 000 similar to 6 000 metres was 1.53 similar to 1.79 times, 1.67 similar to 2.25 times, and 9 times greater, respectively, than the risk in for individuals living below 500 metres. The study also revealed age-specific variations in the risk of depression. Middle-aged and elderly individuals living at altitudes between 500 similar to 2 000 metres are more vulnerable to depression than younger individuals are. In contrast, young people residing at altitudes of 4 000 similar to 6 000 metres face a greater risk of depression than their older counterparts do. These findings highlight the diverse impacts of altitude on the risk of depression across different age groups. In conclusion, this study highlights altitude as a significant risk factor affecting depression among Chinese residents, which suggests the need for targeted mental health interventions that consider both age and altitude. It also challenges the traditional view of age and mental health, suggesting that both individual and environmental factors should be considered in mental health prevention and intervention strategies.

Maintaining independence in instrumental activities of daily living is crucial for older adults in an ageing society. This study, utilizing longitudinal data, aims to explore the relationship between remote intergenerational communication and independent activities in older adults. The sample consisted of 2353 participants from the longitudinal data of the fourth (2016), fifth (2018), and sixth (2020) waves of the China Family Panel Studies. We employed a logistic regression model and a bootstrap test method to analyze the data. The results indicate that each unit increase in remote intergenerational communication reduces the odds of IADL impairment by 14.3

Background Chinese aging population degree will transform mild to moderate. During addressing aging issues by proactive national strategies and healthy aging strategies, the sleep health of older peoplecannot be ignored. Objective To explore the effect of working after retirement on sleep quality in Chinese older people, providing relevant reference data for improving sleep quality in this group of people. Methods In August 2021, data of working after retirement prevalence and sleep health in subjects aged ≥60 years (n=7 862) were obtained from the 2018 China Family Panel Studies (CFPS) conducted by Peking University with permission. They were divided into working after retirement and non-working after retirement groups by working after retirement prevalence. Normal sleep duration (within 4 to 10 hoursper night) , abnormal sleep duration (≤4 or ≥10 hours per night) , sleeping late (going to bed after 23 o'clock) in accordance with relevant diagnostic criteria used in international studies on sleep health in middle-aged and older people. Self-reported perceptions of sleep quality were classified into optimistic and pessimistic according to subjective evaluation of sleep efficiency and effect. Binary Logistic regression model was used to explore the effect of working after retirement on sleep duration, perception of sleep quality and the time to go to sleep. Results Among the subjects, 5 705 (72.56%) had optimistic sleep quality, 6 508 (82.78%) had normal sleep duration, and 7 464 (94.94%) went to sleep earlier than 23: 00, and 4 005 (50.94%) still worked after retirement. After controlling for age, gender, maritalstatus, education level, personality traits and other factors, working after retirement was associated with increased probability of higher optimism with sleep quality〔OR (95%CI) =1.205 (1.069, 1.358) 〕, more normal sleep duration〔OR (95%CI) =1.306 (1.137, 1.499) 〕, and earlier time to go to sleep〔OR (95%CI) =1.596 (1.253, 2.033) 〕.Working after retirement was associated with increased probability of good sleep quality (P<0.05) . Conclusion As working after retirement may be contributive to good sleep quality in older people, it should be supported and guaranteed by governmental policies.

目的:通过调查分析福建省上市药品口服制剂最小销售单元现状,为调整药品包装规格提供参考.方法:以《国家基本医疗保险、工伤保险和生育保险药品目录(2021年)》中的化学药品口服制剂为研究对象,选取福建省药械联合限价阳光采购平台数据,利用SPSS19.0进行数据处理与分析.结果:检索到口服制剂949个,装量范围为1～500片(粒或丸),使用天数范围为0.4～66.7天.装量和使用天数中位数M(P25,P75)分别为20(10,30)、7.2(4.7,13.3).普通药品、慢性病用药和特殊药品在装量和使用天数上存有统计学差异(P＜0.001)."集采"药品较非"集采"药品装量更大,使用天数更长,两者有统计学差异(P＜0.05).销售金额排名前20位的口服制剂装量分布在5～50片(粒或丸)之间,使用天数1～30天不等,其中87.5％的慢性病用药使用天数均＜14天.结论:上市药品慢性病用药(心血管系统、内分泌系统、血液系统用药、抗肿瘤药及免疫调节剂等)装量普遍过小,普通药品(全身激素制剂,泌尿生殖系统药和性激素,肌肉-骨骼系统用药)及特殊药品(第一类、第二类精神药品)装量偏大.建议普通药品最小销售单元装量采用＜7天使用量小包装,慢性病用药采用4周使用量的倍量包装,特殊药品(精神药品、麻醉药品)采用特殊装量包装.

目的:了解流动人口基层首诊现状及其影响因素,为推进流动人口分级诊疗提供实证参考依据.方法:基于2017年全国流动人口动态监测调查数据中82734名最近1次患病(负伤)流动人口数据,利用SPSS 25.0统计软件分析其基层首诊情况及影响因素.结果:82734名最近1次患病(负伤)流动人口中首选到基层医疗卫生机构就诊15936人,基层首诊率仅为19.3％;二分类logistic回归分析结果显示:年龄≥65岁、农业户口、流动时间0～5年、患慢性病、至少参加1项医疗保险,居住地到最近医疗服务机构所需时间≤15 min的流动人口患病后更愿意选择到基层首诊.学历大专及以上、家庭月均收入＞ 10000元、市跨县、东北地区、不愿意落户、自评健康状况为不健康的流动人口患病后更不愿意选择到基层首诊.结论:流动人口患病(负伤)后选择到基层首诊率较低,年龄、受教育程度、户口类型、家庭月均总收入、流动时间、流动范围、流入地区域、落户意愿、自评健康状况、是否患慢性病、有无参加医疗保险、居住地到最近医疗服务机构所需时间是影响流动人口患病(负伤)后选择到基层首诊的主要因素.

目的 了解山东省男男性行为人群(MSM)卫生服务利用现状并探讨其影响因素,为后续艾滋病防治干预提供参考依据.方法 于2021年1月—6月在山东省烟台市、威海市、滨州市3个地区进行匿名调查,收集有效问卷1126份,并采用多元logistic回归模型探讨影响MSM接受预防艾滋病服务及艾滋病病毒(HIV)暴露后预防用药的因素.结果 1126名MSM中最近6个月发生性行为有使用安全套的有893人(79.31％),定期检测996人(88.45％);艾滋病信息知识主要来源于互联网的有943人(83.75％),交友软件931人(82.68％),咨询服务761人(67.58％);接受过预防艾滋病卫生服务的有995人(88.37％);接受过HIV暴露后预防用药的有461人(40.94％).单因素分析结果显示,山东省MSM接受预防艾滋病卫生服务在年龄、月收入、性取向、固定性伴侣、商业性行为、酒后性行为、近6个月发生性行为时的安全套使用及艾滋病防治素养上的差异具有统计学意义(P均<0.05);接受过HIV暴露后预防用药在年龄、配偶、户籍、文化程度、月收入、性取向、固定性伴侣、无商业性行为、酒后性行为、近6个月发生性行为时的安全套使用及艾滋病防治素养上的差异具有统计学意义(P均<0.05).多因素logistic回归分析结果显示,无固定性伴侣、近6个月发生性行为时不使用安全套、不具备艾滋病防治素养的MSM接受预防艾滋病服务的可能性更小.无配偶、同性恋、有固定伴侣、无商业性行为、无酒后性行为、近6个月发生性行为时有使用安全套、具有艾滋病防治素养的MSM更愿意接受HIV暴露后预防用药.结论 山东省MSM接受过预防艾滋病卫生服务率较高,但接受过HIV暴露后预防用药的比例较低.应通过加强对HIV暴露后预防用药的宣传,降低相关药品价格,增加艾滋病预防药物售卖点等途径,通过线上线下相结合的方式提高卫生服务利用率,降低艾滋病传播风险.

目的:探讨中青年流动人口慢性病防治教育现状及其影响因素,为提高中青年流动人口慢性病防治素养和促进慢性病防治教育服务和政策的制定提供参考依据.方法 基于2017年全国流动人口动态监测调查数据中14 8850名15～59岁中青年流动人口数据,利用SPSS 25.0统计软件分析其接受慢性病防治教育现状及影响因素.结果:14 8850名中青年流动人口中接受慢性病防治健康教育55 566人,接受率为37.3％;其中,15～35岁青年和36～59岁中年流动人口慢性病防治健康教育接受率分别为36.8％、38.0％.慢性病防治教育接受方式主要为宣传资料(纸质、影视)、宣传栏/电子显示屏、公众健康咨询、健康知识讲座、社区短信/微信/网络和个性化面对面咨询,分别占93.6％、86.1％、64.9％、59.5％、53.2％和44.0％.二元Logistic回归分析发现,男性、36～59岁、已建立健康档案、听说过"国家基本公共卫生服务"、患有慢性病、流动原因为经商、完全愿意融入本地人的中青年流动人口更倾向于接受慢性病防治健康教育.教育程度为小学及以下、家庭月总均收入≥10000元、跨省、无医疗保险、居住地到最近医疗机构所需时间≥15分钟的中青年流动人口更不倾向于接受慢性病防治教育.结论:中青年流动人口慢性病防治教育接受率较低,不同性别、年龄、受教育程度、家庭月均总收入、流动范围、流动原因、是否建立健康档案、是否听说"国家基本公共卫生服务"、是否患慢性病、医疗保险和居住地到最近医疗机构所需时间是影响中青年流动人口慢性病防治教育接受率的主要影响因素.

ObjectiveTo examine the acceptance of mental health education and its associates among elderly migrants and to provide evidences for developing strategies and programs to promote mental health education service and mental health literacy in the population. MethodsThe data on 5 729 migrant people aged 60 years and above and living locally at least 6 months were extracted from the China Migrants Dynamic Survey conducted in 31 provincial level administrative divisions across China in 2017. SPSS 25.0 was used in data analyses. ResultsAmong all the participants, only 29.2% (1 672) reported having received mental health education during past one year in villages/communities and the reported proportions were 29.2%, 30.5%, 29.9%, and 24.2% in the participants aged 60 – 64, 65 – 69, 70 – 74, and ≥ 75 years, respectively. The major patterns of the mental health education were via publicity materials (papers, films and television programs), billboards/electronic displays, public health consultation, and health knowledge lectures, which were reported by 90.1%, 82.0%, 70.0%, and 67.5% of the 1 672 health education receivers; other two patterns reported by 48.8% and 39.4% of the receivers were via personalized face-to-face consultation and via community short message service/WeChat/networks. The results of binary logistic regression analysis showed that the participants with following characteristics were more willing to receive mental health education service: immigrating to regions in western China, having personal health records being established, being aware of national basic public health service, with a good self-rated health, with a strong willingness to integrate into local social environment, and having a high community involvement; while, aged 75 years and above, with the education of primary school or below, with difficulties in local region, experiencing the migration for more than 10 years, and migrating due to the migration of family members such as the elderly or children to be cared were less likely to receive mental health education. ConclusionIn elderly migrant population in China, the acceptance of mental health education was at a relatively low level and mainly influenced by age, education, whether having difficulties in local region, self-rated health, duration of migration, reasons for migration, inflow region, the awareness about national basic public health services, the establishment of personal health record, community involvement, and the willingness to be assimilated into local social environment.

目的:调查分析自我关怀能力、家庭关系状况对上海高校大学生状态和特质焦虑的影响,为缓解大学生焦虑情绪提供参考.方法:基于分层整群随机抽样方法,采用自我关怀量表(SCS)、家庭亲密度和适应性量表(FACESII-CV)及状态和特质焦虑量表(STAI)对887名上海高校大学生进行调查.结果:上海高校大学生自我关怀总分为2.59±0.80分,内部维度自我友善、正念、共通人性、自我批评、过度沉溺、自我孤立得分依次为2.77±0.96、2.40±0.83、2.83±0.84、2.24±0.89、2.60±1.09、2.61±0.91分;家庭关系亲密度和适应性得分为3.79±0.39、3.11±0.42分;状态焦虑和特质焦虑得分为45.46±8.06、43.75±7.82分.不同性别、年龄、年级、独生子女情况、户籍性质组大学生状态和特质焦虑得分差异有统计学意义(P＜0.01).自我友善、正念、共通人性得分及家庭关系亲密度、适应性得分对状态和特质焦虑得分有负向预测效应(P＜0.05);自我批评、过度沉溺得分对状态焦虑得分有正向预测效应(P＜0.01);过度沉溺、自我孤立得分对特质焦虑得分有正向预测效应(P＜0.01).结论:上海高校大学生存在明显的状态焦虑,女性、年龄较大、高年级、非独生子女、农村户籍大学生是状态和特质焦虑的高危人群,可通过提高大学生内在自我关怀能力和改善所处家庭关系状况缓解其焦虑情绪.

目的:探讨工作满意度现状及对劳动者睡眠的影响,为提高劳动者的睡眠质量,促进其身心健康提供参考.方法:利用2018年中国家庭追踪调查数据库,选取人口学特征指标、五大人格量表、睡眠特征指标及工作满意度量表,通过使用多元逐步回归、有序逐步回归的方法分别探讨工作满意度对睡眠时长、入睡时间、睡眠质量的影响.结果:30～45岁劳工的工作满意度得分由高到低依次为:工作安全满意度3.71±0.97分、工作环境满意度3.51±1.02分、工作时间满意度3.49±1.05分、工作晋升满意度3.30±1.05分、工作收入满意度3.26±1.03分,均介于一般至满意之间,平均睡眠时长为7.75±1.25小时,平均入睡时点为22:17±1.04,大约47.61％的劳动者睡眠质量较好;通过逐步多元回归发现:控制学历、婚姻、个性等变量后,工作安全性满意度与工作时间满意度越低的劳工,其睡眠时长更容易小于5个小时(P＜0.05),而年龄越低、学历越低、农村户籍农民工其的睡眠时长更大概率会睡超过9小时(P＜0.05);逐步有序回归发现工作收入满意度越高、工作安全满意度越高、工作环境满意度越高、工作时间满意度越高、工作晋升满意度越高睡眠质量越好;男性比女性睡眠质量高,年龄越小、无慢性病、情绪不稳定得分越低者睡眠质量越好.结论良好的工作环境、合理晋升机制以及劳工对职业的认同对提高劳工的睡眠质量存在正向关联,因此相关部门要为青壮年劳工创建安全的工作环境,合理提高劳动者工作收益从而缓解其身心压力,保证睡眠质量.

Introduction Depression has become a prominent psychological problem among young people. The purpose of this study was to investigate the potential relationship between the frequency of Internet use, family atmosphere, academic performance, self-adjustment, campus deviant behavior, and depressive symptoms among adolescents. Methods Based on the survey data of the fifth wave (2017~2018) and the sixth wave (2019~2020) of the China Family Panel Studies (CFPS), this study used LISREL8.8 software to analyze 1,577 10~15 data on adolescents. Results In this study, the mean score of self-adjustment was 42.40 (SD = 6.79), the mean score of campus deviant behavior was 12.59 (SD = 4.00), the mean score of depressive symptoms in 2018 was 11.88 (SD = 3.04), and the mean score of depressive symptoms in 2020 was 7.64 (SD = 2.20). Secondly, the frequency of Internet use had no direct effect on the depressive symptoms of adolescents, family atmosphere was negatively correlated with depressive symptoms ( p < 0.005), and academic performance was positively correlated with depressive symptoms ( p < 0.005). Depressive symptoms in 2020 had a direct effect ( β = 0.37, p < 0.001), and also had a negative effect on depressive symptoms in 2020, with a total effect of-0.07 ( p < 0.001); self-adjustment had no direct effect on depressive symptoms in adolescents in 2018, However, the total effect was −0.14 ( p < 0.001), which had a significant positive effect on 2020 depressive symptoms, and the total effect was 0.18 ( p < 0.001), and self-adjustment had a significant negative effect on adolescent campus deviant behavior ( β = −0.38, p < 0.001); in addition, the frequency of Internet use, family atmosphere, and academic performance all had indirect effects on adolescents’ 2020 depressive symptoms, with total effects of −0.60, 0.01, and 0.02 ( p < 0.001), respectively. This study also found depressive symptoms in adolescents have a certain persistence in time. Discussion Based on this study, it is necessary to pay more attention to the depression of adolescents, strengthen the training of self-adjustment, improve the anti-frustration ability and psychological resilience, and reduce the campus deviant behavior of adolescents. It is recommended to try to start from emotional self-adjustment to promote the personality health of adolescents.

目的:探究各利益主体在总额预付制度实施中出现的利益冲突,并探寻其最佳的解决方案,以期推动总额预付制在未来长期可持续发展.方法:依据利益相关者理论方法,描述总额预付制度在具体实施中出现的利益冲突主体,并通过冲突分析图模型,分析多方利益主体在总额预付制发展中的博弈均衡解,并求得最优的解决方案,以期预测未来冲突的事态发展趋势以及最终的结果.结果:通过实证模型,共获得256个状态点,经删除不可行状态和状态转移处理后执行稳定性分析,最终获得各个利益冲突主体均能接受的12个均衡解.结论:合理确定预算总额是优化总额预付制度的基础;精细化管理是实行总额预付制度的有效途径;以总额预付为主、多种支付方式并存的混合支付模式有利于促进医疗制度的改革;加强医保政策的宣传有利于总额预付制长期可持续发展.

通过构建多水平曲线发展模型分析发现,社区环境与个人因素相交叉对居民健康变化轨迹的影响约占22.9％.其中,个人经济社会条件与城乡分类、社区内医疗服务机构数量的交互项显著影响了居民健康均值,与医疗服务效能的交互项显著影响了居民健康的变化幅度,社区内工作人员数量、居民同质性等因素显著影响居民健康变化的加速度.因此,在"健康中国"社区实践中,需注重居民收入等个人特征与社区环境的互动性变化,在健康"软资源"方面积极作为,优化社区健康资源供给策略.

目的:把握福建省流动人口健康档案建立现状及其影响因素,为实现流动人口基本公共卫生服务均等化,促进和提高流动人口的健康水平提供参考依据.方法:基于全国流动人口动态监测中2018年福建省的调查数据,利用SPSS 25.0统计软件分析有关福建流动人口健康档案建立状况及其影响因素.结果:福建省9个地区市的6020名流动人口随机抽样样本中,建立健康档案者1228人,建档率为20.4％,未建立健康档案者和不清楚是否建档者分别为4022人(66.8％)和770人(12.8％).健康档案无序多分类logistic回归分析结果显示:受教育程度低、年龄≥50岁、农业户口、家庭月总收入≤5000元、未签约家庭医生、调查点类型为村委会、跨省流动的男性流动人口是福建省地区中流动人口健康档案建设的薄弱人群,同时发现签约家庭医生对流动人口健康档案的推进有积极的促进作用.结论:福建省9个地区流动人口的健康档案建档率较低,亟待提高.性别、年龄、受教育程度、户口类型、家庭月总收入、是否签约家庭医生、调查点类型、流动范围与流动人口健康档案建立存在统计学上显著性关联.各级政府应重点关注与服务建档薄弱对象.同时还应在政策上加大推进家庭医生签约服务以提高健康档案建档率.

With increasing age, middle-aged and older persons face a series of physical and mental health problems. This study aimed to explore the latent relationships among age, functional disability, depression, and life satisfaction. The data were obtained from the Wave 2 (in 2013–2014) and Wave 3 (in 2015–2016) surveys of the China Health and Retirement Longitudinal Study. The analytic sample in the present study included 15,950 individuals aged 45 years and over. The participants answered the same questions concerning depression and life satisfaction in both study waves, and functional disability was measured based on the activities of daily living and instrumental activities of daily living. Age was directly associated with functional disability, life satisfaction, and depression. Functional disability was positively correlated with depression and negatively correlated with life satisfaction. Functional disability strongly mediated the relationships among age, depression, and life satisfaction. Depression and life satisfaction were found to have enduring effects and effects on each other. Additionally, the model revealed a gender difference. Depression in middle-aged people should receive closer attention. Avoiding or improving functional disability may be an effective way to improve life satisfaction and reduce the level of depression in middle-aged and older persons. If prevention work successfully decreases depression, the life dissatisfaction of middle-aged and older people could be improved. Additionally, for the prevention of functional disability and depression and improvement in life satisfaction, gender differences need to be considered.

目的 了解山东省男男性行为人群(men who have sex with men,MSM)压力现状,探讨影响其心理压力、家庭压力及社会压力的主要因素,为缓解性此类群体压力,提升其健康水平提供参考依据.方法 于2021年1-6月在山东省烟台市、威海市、滨州市3个地区进行匿名调查,收集有效问卷979份,并采用多元logistic回归模型探讨影响MSM心理压力、家庭压力及社会压力的因素.结果 有心理压力127人(12.97％),面临父母催婚压力244人(24.92％),感受到社会的压力123人(12.56％).多因素logistic回归分析结果显示,本身喜欢同性相比醉酒或在无意识情况下发生同性关系(OR=6.75,95％CI=81.19～9003.48)、他人诱导(OR=3.95,95％CI=6.37～ 426.27)、好奇心使然(OR=2.97,95％CI=2.45～154.39)的MSM心理压力更突出;月收入＞10000元相比月收入较低的MSM家庭压力更大,相比于月收入＞10000元,月收入较低的MSM受到的社会压力更大;外地户籍、无固定性伴侣、未接受预防艾滋病病毒服务、未定期检测及感到性取向对生活产生不便的MSM的心理压力、家庭压力、社会压力更为明显.结论 山东省MSM队列承受家庭压力最大,有必要关注引发其家庭、心理、社会压力的各项因素,加强对MSM的心理健康干预,加强社会支持力度,帮助其缓解各项压力.

通过对2015-2020年千余篇养老服务文献计量分析发现,当前我国智慧养老服务的最大问题可以概况为资源整合度层次较低、科技适老性不高等问题.通过对各地养老实践的梳理,认为这些问题并非智慧养老服务本身特有的问题,而是新瓶装旧酒,即传统养老服务中尚未解决的管理碎片化、养老服务供需偏差问题在智慧养老中又以新的形式展现出来.借鉴对发达国家智慧养老实践经验,欲解决此问题,须回到服务本质上来,坚持"以人为本",政府当好"掌舵人",为智慧养老保驾护航.政府可以从顶层设计与科技适老能力提升两个方面入手,进一步完善养老服务信息平台,推动智慧养老行业标准与信息标准化建设,界定基本养老服务对象及其服务内容,资助老年人科技养老研究项目,并开展老年人科技操作能力的培训.