ABSTRACT
ObjectiveTo determine the seroprevalence of anti-Streptococcus pneumoniae immunoglobulin G （IgG） antibody and its risk factors in the elderly attending physical examination. MethodsTwo communities were randomly selected， in which the elderly aged over 60 years attending physical examination in the community health care centers were included in the study. A questionnaire survey was conducted， companied by examination for serum anti-Streptococcus pneumoniae IgG antibody. In addition， data of physical examination was collected. Chi-square test and multivariate logistic regression were utilized to determine the risk factors associated with seroprevalence of anti-Streptococcus pneumoniae antibody. ResultsA total of 635 participants were included. The average age was （73.2±7.4） years old. Forty-nine （7.72%） participants tested positive for anti-Streptococcus pneumoniae IgG antibody. The seroprevalence differed by gender （6.49% in male and 8.86% in female）， smoking （5.48% in smokers and 8.01% in non-smokers）， history of pneumonia （7.89% in those suffered from pneumonia in the past year and 7.71% in those didn’t have pneumonia）， history of common cold （10.38% in those had common cold in the past year and 5.87% in those didn’t have cold）， obesity （15.62% in those with obesity and 6.83% in those without obesity）. Further multivariate logistic regression showed the seroprevalence of anti-Streptococcus pneumoniae IgG significantly increased in the elderly with history of common cold （OR： 2.24； 95%CI： 1.21‒4.14）and obesity （OR： 2.81； 95%CI： 1.26‒6.26）. ConclusionSeroprevalence of anti-Streptococcus pneumoniae IgG antibody is low in the elderly attending physical examination. It warrants improving the vaccination of pneumococcal polysaccharide vaccine for the elderly with obesity and susceptibility to common cold.
ABSTRACT
Objective To explore the inclusion criteria of community-based palliative care service.Methods From July 2017 to September 2017,three rounds of Delphi consultation for development of inclusion criteria of community-based palliative care was conducted.With judgment sampling method,23 senior executives and managers from 6 pilot units of palliative care service in Shanghai were selected and invited to participate in the consultation,which included the importance,coercion and completeness of the inclusion criteria.According to the consulting results,the inclusion criteria of community palliative care services was developed.Results The median age of experts was 35 years (29-55 years,with a quartile spacing of 7 years).The average working experience of experts was (13.7 ± 7.5) years,in which that for palliative care was (4.1 ± 1.6) years.The authority coefficient was 0.82,and the Kendall coordination coefficient was 0.337 (P＜0.01) for the importance of inclusion criteria.In the developed criteria,the four mandatory inclusion criteria were patient needs,the provision ability of community health service centers,compliance with legal requirements and compliance with the concept of palliative care service;and the five non-mandatory inclusion criteria were heavy needs and demands,high cooperation from patients and their families,high satisfaction of patients and their families,within the scope of community health service centers and clinical guidelines for the operations.Conclusion The experts of this research have high enthusiasm and authority,and the developed inclusion criteria of community palliative care service contents are reasonable and feasible.This studymay provide reference for setting up the contents adjustment mechanism of community-based palliative service.