Association between education and the onset of disability in activities of daily living in middle-aged and older Chinese adults: The mediator role of social participation / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association between educational attainment and the onset of disability in activities of daily living (ADL), and to explore the mediating effect of social participation on such association.@*METHODS@#A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2015 to 2018). The measurements of educational attainment, social participation and other covariates were identified from 2015, while the outcome measurement of ADL disability was constructed with data from survey 2018. Descriptive analyses were conducted, and basic characteristics and social engagement of the respondents were compared between illiterates and non-illite-rates using Chi-square test. Logistic regression was used to investigate the associations of educational attainment and social participation on the onset of ADL disability. Mediation analysis was employed to examine the mediator role of the social participation on the linkage from being illiterate to the ADL disability onset.@*RESULTS@#A total of 11 359 adults aged 45 years and above were included in the sample, of whom 3 222 were illiterates. The incidence of the onset of ADL disability of illiterates and non-illiterates were 10.4% and 6.2%, respectively. Among these respondents, only half of them were involved in social activities. Of all the 8 social activities, the percentage of interacting with friends (34. 1%) was the highest, and the lowest percentage was observed in participating in an educational or training course (0.6%). Moreover, the percentages of participation in all these 8 social activities among illiterates were significantly lower than that of their educated counterparts (all P < 0.001). The illiterate middle-aged and older adults were less likely to develop ADL disability in the follow-up period [adjusted odds ratio (aOR)=1.22, 95%CI: 1.02-1.45], and social participation was significantly associated with ADL disability onset (aOR=0.73, 95%CI: 0.63-0.85). Findings from mediation analysis illustrated that social participation accounted for 12.22% of the adverse effect of being illiterate on ADL disability onset.@*CONCLUSION@#Social participation could buffer the negative effect of being illiterate on ADL disability onset in middle-aged and older adults, suggesting that engagement in social activities might have impact on prevention of impairments in physical function, especially for middle-aged and older illiterates.

Prediction of Prenatal Ultrasound Screening Staff's Situation in Beijing Based on ARIMA Model / 中国医学科学院学报

Objective To understand the current situation and predict the trends in number and composition of prenatal ultrasound screening staff in Beijing. Methods We analyzed the region,age,professional title and other characteristics of prenatal ultrasound screening personnel in Beijing during 2007-2015.We then built an ARIMA model basing on the current situation to predict the number and composition of the staff in 2016-2020. Results The number of prenatal ultrasound screening staff showed an upward trend in 2007-2020 and was predicted to reach 1269 in 2020.During this period,the educational achievement and professional title of the staff showed a downward trend,and the working years became shorter,mainly below 5 years.The proportion of resident doctors remained at 26.6%,and that of the staff receiving further education would reach 43.2% by the end of 2020. Conclusion The prediction under ARIMA model suggests that efforts should be made to strengthen the training of young doctors and provide them opportunities for further study.

Operation of Prenatal Ultrasound Screening Institutions in Beijing from 2010 to 2015 / 中国医学科学院学报

Objective To learn the capability and functioning status of prenatal ultrasound screening institutions in Beijing and inform decision-making on the optimization of prenatal screening management. Method By using the data from the second and the third National Special Survey on Prenatal Screening and Prenatal Diagnostic Services in Beijing,we analyzed the distribution,human resources,workload,technology,and equipment of ultrasound screening institutions in Beijing as well as their changing trends. Results From 2013 to 2015,there were 100 prenatal ultrasound screening institutions,833 technicians,and 383 prenatal ultrasound screening instruments in Beijing,offering over 600 000 service sessions.In contrast,there were 93 institutions with a total service volume of 644 100 between 2010 and 2012.The general hospitals,tertiary hospitals,and urban areas(especially urban functional development areas and new urban development areas)were the main sources of the services.In particular,the maternal and child health care hospitals in Beijing provided the highest amount of services per unit of resources.The average prenatal ultrasound screening rate was about 98.05%.The service delivery trended to transfer from urban areas to remote county areas and from secondary institutions to tertiary institutions.Conclusion The operation and management of prenatal ultrasound screening institutions in Beijing are relatively standard.The ultrasound screening rate is relatively high in the second trimester,and the distribution of the services has constantly been improved since 2010.

Comparing Different Weights to Construct Composite Indicators of Maternal and Child's Basic Health Services from the Prospective of Continuum of Care:Based on Data from the National Health Services Survey 2008 and 2013 in Jilin Province / 中国医学科学院学报

Objective To construct composite indicators of maternal and child's basic health services using different weights from the prospective of continuum of care and to compare them based on data from the National Health Services Survey 2008 and 2013 in Jilin Province. Methods The study selected indicators based on the countdown and the Lives Saved Tool(LiST),considering the data availability from the 2008 and 2013 National Health Surveys in Jilin.Equal weights,equal weights for different areas,epidemiology weights,and principal component weights were used to construct different composite indicators.Cronbach's alpha reliability coefficient was used to test the internal consistency.Analysis of variance of randomized block design was used to test the differences.The Spearman's correlation coefficient was calculated to compare the rank correlation.The maternal mortality,children under 5 years old mortality rate,and children under 5 years old stunting incidence were used as the outcome indicators to test the validity using correlation analysis. Results Finally 13 indicators were selected,with the Cronbach's alpha reliability coefficient value exceeding 0.7,which means acceptable internal consistency of these indicators.Analysis of variance showed that the scores were not significantly the same(F=8.14,P<0.01).The rank correlations among equal weights,principal component weights,and equal weights for different areas composite indicators were quite strong,and the Spearman's correlation coefficient between either two were all above 0.9,while the epidemiology weights composite indicator got smaller Spearman's correlation coefficient with equal weights,principal component weights,and equal weights for different areas composite indicators(0.697,0.671,and 0.818,respectively).The composite indicator using epidemiology weights showed significant negative correlation with children under 5 years old mortality rate and children under 5 years old stunting incidence(R=0.168,P<0.05;R=0.398,P<0.01,respectively).The composite indicators using equal weights,equal weights for different areas and principal component weights only showed significant negative correlation with children under 5 years old stunting incidence(R=0.238,R=0.304,R=0.232,P<0.01 for all,respectively).Conclusion The composite indicator using epidemiology objective weights has some predictive value for maternal and child health outcomes.