Características socioantropológicas y de salud de un asentamiento urbano desde la perspectiva de enfermería

RESUMEN Introducción: Se realizó una investigación de desarrollo tecnológico en el período 2019-2020 en Previsora, comunidad urbana, de Camagüey. Su ejecución fue liderada por investigadores y profesionales de enfermería comunitaria. El objetivo del presente trabajo está dirigido a caracterizar la comunidad desde la perspectiva histórico social y de salud para la identificación de las necesidades de aprendizaje de los profesionales de enfermería comunitaria. Métodos: Se realizó un estudio etnográfico como método de recopilación descriptivo de datos a partir de la combinación de técnicas y fuentes; de ellas se especifica: grupos focales, entrevista a profundidad, entrevista estructurada abierta y la observación participante y dentro del método cuantitativo: entrevista estructurada cerrada; así como los elementos más significativos del Análisis de la Situación de salud. Se realizó una triangulación teórica y metodológica de técnicas, instrumentos y fuentes en correspondencia con la metodología cualitativa y cuantitativa, según el momento de la investigación. Resultados: Se evidenció falta de sentido de pertenencia de los pobladores, indisciplinas sociales que perjudican la comunidad y su salud, deterioro de las relaciones interpersonales, sistema eco cultural deficiente y se identificó la necesidad de emprender otras acciones comunitarias que inciten el cambio y modifiquen el cuadro de salud comunitaria. Discusión: Los resultados que se exhiben coinciden con los de investigaciones desarrolladas por prestigiosos profesionales de las ciencias sociales y humanísticas.

ABSTRACT Introduction: A technological développent investigation was carried out in the period 2019-2020 in Previsora, an urban community, in Camagüey. Its execution was led by researchers and community nursing professionals. The objective of this work is aimed at characterizing the community from a historical, social and health perspective in order to identify the learning needs of community nursing professionals. Methods: An ethnographic study was carried out as a method of descriptive data collection from the combination of techniques and sources; of them are specified: focus groups, in-depth interview, open structured interview and participant observation and within the quantitative method: closed structured interview; as well as the most significant elements of the Health Situation Analysis. A theoretical and methodological triangulation of techniques, instruments and sources was carried out in correspondence with the qualitative and quantitative methodology, according to the moment of the investigation. Results: Lack of sense of belonging of the inhabitants was evidenced, social indiscipline that harms the community and its health, deterioration of interpersonal relationships, deficient eco-cultural system and it was identified the need to undertake other community actions that incite change the environment and modify the community health chart. Discussion: The results that are exhibited coincide with those of research carried out by prestigious professionals in the social and humanistic sciences.

Prevalence of physical activity and dietary patterns as risk factors for cardiovascular diseases among semi-urban dwellers in Ibadan, Nigeria

Background: Physical inactivity and unhealthy diet are leading risk factors for cardiovascular diseases globally. Limited studies have assessed the prevalence of these risk factors in community-based settings in Nigeria. Objectives: This study assessed the prevalence of physical activity and the dietary pattern of residents in selected semi-urban communities in Ibadan, Nigeria. Methods: This was a cross-sectional study carried out among 500 randomly selected residents from two semi-urban communities. Multi-stage random sampling technique was used to select households and participants. Data were collected using a pretested modified version of the WHO STEPS instrument. Descriptive and inferential statistical analyses were determined at 5% level of significance. Results: The mean age was 35.36 ± 12.24 and a mean household size of 4.07 ± 1.85. Majority (87.2%) of the respondents engaged in low physical activity (< 150-300 min/wk). Consumption of fruits and vegetables was low among respondents at 33% and 36.4% respectively. The employment status of respondents was significantly related to expected workplace physical activity level (χ2=11.27; P=0.024). Conclusions: This study highlights the need for the development and implementation of community-driven, multi-layered public health promotion initiatives across different settings

Determination of prevalence, knowledge, attitude and practices of contraceptive use in an urban population in South India: a community based study

Background: Family planning influences mothers and infant’s health, population growth and regional and national development. Studying the knowledge, attitude and practice of contraceptive methods of a region aids in overcoming the barriers in the utilization of the services providing them.Methods: A community based cross sectional study was done among 350 married women of an urban population by systematic random sampling using a structured questionnaire.Results: From a total of 350 women enrolled, majority were of the Hindu religion (84.9%) and from the lower socio-economic status (68%). The prevalence of use of contraceptive methods was 75.4% and it was predominantly female sterilization. It was significantly higher (p<0.001) in women aged above 32 years, married for more than 10 years, having more than two children and last child birth of more than seven years. Only 142 (40.6%) of the participants had adequate knowledge of contraceptive methods. However, 299 (85.4%) had a positive attitude to contraception and 296 (84.6%) had good practice of family planning (FP) methods.Conclusions: The knowledge and use of contraceptive methods especially temporary methods needs to be improved in our community. The utilization of media can be improved in addressing this shortfall. Health care providers being the bulk source of information on contraceptive methods must be pro-active in every interaction with women and men of reproductive age group by providing information on the various methods.

Investigation on Mental Health Status of Digestive Tract Symptomatic Population in Beijing Urban Community Based on SCL-90 Psychological Scale / 胃肠病学

Background: The impact of mental health status on digestive tract symptoms has attracted more attention, however, the mental health status in people with long-term digestive tract symptoms is not yet clear. Aims: To investigate the mental health status of Beijing urban community residents with digestive tract symptoms. Methods: A total of 205 urban community residents who voluntarily participated in the community general examination of digestive tract from March 2016 to December 2017 in six communities around Fuxing Hospital were enrolled, and were divided into digestive tract symptoms group and without digestive tract symptoms group. Symptom checklist 90 (SCL-90) was used to measure the psychological status. Results: Compared with the residents without digestive tract symptoms, score of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, hostility were significantly increased in digestive tract symptoms group (P0.05). Further analysis showed that score of somatization, obsessive-compulsive symptoms, anxiety, hostility were significantly increased in residents with abdominal distention than those without abdominal distention (P<0.05); score of all the 9 factors were significantly increased in residents with acid regurgitation, heartburn, eructation than those without acid regurgitation, heartburn, eructation (P<0.05); score of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression were significantly increased in residents with postprandial distress than those without postprandial distress (P<0.05). Education had some effects on somatization, obsessive-compulsive symptoms, hostility in the residents with digestive tract symptoms (P<0.05). Conclusions: The urban community residents with digestive tract symptoms in Beijing have obvious mental health problems when compared with those without digestive tract symptoms, especially somatization and obsessive-compulsive symptoms.

Youth and neighborhood effect in southern European cities: some pending issues to analyze / Juventud y efecto barrio en las ciudades del sur de Europa: algunos aspectos pendientes deanalizar / Juventude e “efeito vizinhança” nas cidades do sul da Europa: alguns aspectos pendentes de análise

This is a theoretical paper, which presents a systematic and critical review of different authors about the neighborhood effect and the State’s role in the life paths of young people and introduces reflections, contributions and nuances that have emerged from an empirical work, with the intention of advancing the conceptual reflection of phenomena such as neighborhood effect and processes of youth social exclusion on the outskirts of the city. The methodology chosen is the comparative case study among four working class neighborhoods in the periphery of Barcelona and Milan. Finally, main conclusions are: previous researches about neighbourhood effect have ascribed other elements to the neighbourhood leading to social exclusion, even when they are not created by neighbourhood itself, but they are the result of extra-territorial and extra-local processes.

Este es un artículo teórico que por un lado, presenta una revisión sistemática y crítica sobre la literatura del efecto barrio y el papel del Estado en las trayectorias devida de los jóvenes, y por otro lado, introduce reflexiones, aportaciones y matices que han surgido deun trabajo empírico, con la intención de promoverla reflexión conceptual sobre el efecto barrio y losprocesos de exclusión social juvenil en las periferias urbanas. La metodología elegida es el estudiode caso comparativo entre cuatro barrios de la clase obrera en la periferia de Barcelona y Milán. Los principales resultados son que investigaciones precedentes sobre el efecto barrio han atribuidoal barrio elementos vinculados a la exclusión social, incluso cuando estos procesos no son creados por el propio barrio, sino que son el resultado de procesos extra-territoriales y extra-locales.

Este é um artigo teórico que por um lado apresenta uma revisão sistemática e crítica da literatura do “efeito vizinhança” e o papel do Estado nas trajetórias de vida dos jovens e, por outro lado, introduz reflexões, aportes e matizes que têm surgido de um trabalho empírico, com a intenção de promover a reflexão conceitual sobre o efeito de vizinhança e processos de exclusão social de jovens nas periferias urbanas. A metodologia escolhida é o estudo de caso comparativo entre quatro bairros de classe operária na periferia de Barcelona e Milão. Os principais resultados são que as pesquisas anteriores sobre o “efeito vizinhança” atribuíram à vizinhança elementos vinculados à exclusão social, incluso quando estes processos não são criados pela própria vizinhança, mas são o resultado de processos extraterritoriais e extra locais.

Analysis of the Influencing Factors and Countermeasures on the Subjective Well-being of Female Elderly in Urban Community / 中国医学伦理学

Objective:To explore the subjective well-being and its influencing factors of female elderly in ur-ban community in Shandong province. Methods: Used the multi-stage stratified sampling method to extract 449 elderly women in 6 communities of 18 cities in Shandong Province. The basic situation and Subjective well-being of their were investigated by using the self-designed questionnaire and Memorial University of Newfoundland Scale of Happiness ( MUNSH) . Results:The economic situation, the number of children, living conditions, self-care ability, chronic disease severity, and other variables have a significant effect on the subjective well-being of fe-male elderly. Conclusions:To improve the economic situation of the urban community elderly women, pay atten-tion to their physical and mental health level, improve the pension and health insurance system, intensify the con-struction of old-age care institutions, playing the roles of family, children, society in the network to support the community elderly women society, can significantly improve the community elderly women′s subjective well-be-ing.

Plantas medicinais conhecidas na zona urbana de Cajueiro da Praia, Piauí, Nordeste do Brasil / Known medicinal plants found in the urban Cajueiro da Praia urban area, Piauí state, Northeast Brazil

RESUMO A utilização de plantas com fins medicinais para tratamento, cura e prevenção de doenças é considerada uma das mais antigas formas de prática medicinal da humanidade. O presente estudo teve como objetivo identificar as espécies de plantas medicinais usadas dentro da comunidade de Cajueiro da Praia, Piauí, bem como a parte da planta utilizada, o modo de preparo, a sua importância relativa, o valor de uso e o consenso em relação às propriedades terapêuticas das espécies citadas. Foram aplicadas 12 entrevistas semiestruturadas com especialistas locais indicados, utilizando o método de amostragem por “bola-de-neve” e a técnica de “turnê-guiada” para coleta das espécies citadas. Análises quantitativas tais como Valor de Uso, Importância Relativa e Fator de Consenso dos Informantes foram associadas à análises qualitativas. As coletas botânicas seguiram a metodologia usual. Foram citadas 43 espécies, distribuídas em 24 famílias botânicas, sendo Lamiaceae a mais representada em número de espécies (oito espécies), seguida de Euphorbiaceae, Fabaceae, Myrtaceae e Rutaceae (todas com três). Chenopodium ambrosioides L. (mastruz) obteve o maior valor de uso (VU=1,58), sendo portanto, a planta com elevado potencial de uso para a comunidade. Quanto ao uso terapêutico, observou-se que um maior número de espécies foi indicado no combate à gripe, seguido por má digestão. O IR demonstrou que planta mais versátil foi Chenopodium ambrosioides L. (mastruz), com IR=2, referido em cinco categorias de uso e o FCI apontou que os sistemas corporais que apresentam maior importância local são: sistema circulatório (FCI=0,57), seguido por lesões e consequências de causas externas (FCI=0,50), sistema endócrino (FCI=0,50) e respiratório (FCI=0,40). No âmbito geral, verificou-se que a diversidade de plantas medicinais conhecida e a obtenção das plantas na comunidade estudada sugerem uma correlação entre uso/conhecimento de plantas medicinais e disponibilidade das mesmas; que a flora medicinal é representada, em boa parte, por plantas exóticas cultivadas nos quintais e que a transmissão do conhecimento tradicional feito localmente e por via oral demonstra uma herança cultural na cidade.

ABSTRACT The use of medicinal plants for the purposes of treating, curing and preventing diseases is considered one of the oldest forms of humanity’s medical practices. This study aimed to identify the species of medicinal plants used in the Cajueiro da Praia community, Piauí state, the part of the plant used, the method of preparation, their relative importance, the use value and the consensus on the therapeutic properties of the species mentioned. 12 semi-structured interviews with indicated local experts were performed, using the “snow-ball” sampling method and the “guided tour” technique to collect the aforementioned species by a standardized method. Quantitative analyzes such as Use value, relative importance and informant consensus factor were performed alongside qualitative analyzes. 43 species belonging to 24 botanical families were cited, Lamiaceae being the most represented in number of species (eight species) followed by Euphorbiaceae, Fabaceae, Myrtaceae and Rutaceae (with three each). Chenopodium ambrosioides L. (mastruz) had the highest use value (UV = 1.58), and therefore was the plant with the highest potential for use by the community. For therapeutic use, it was observed that a greater number of species have been shown to combat influenza, followed by maldigestion. The RI showed that the most versatile plant was Chenopodium ambrosioides L. (mastruz) with RI = 2, found in five usage categories and the ICF pointed out that the bodily systems that have greater local importance are: the circulatory system (ICF = 0.57), followed by lesions and consequences by external causes (ICF = 0.50), the endocrine (ICF = 0.50), and the respiratory system (ICF = 0.40). Within the general framework, it was found that the diversity of known medicinal plants and plants obtained from the population studied, suggested a correlation between the use/knowledge of medicinal plants and the availability there of; the medicinal flora is largely represented by exotic plants that are grown in backyards andby the transmission of traditional knowledge made locally and orally demonstrates a cultural heritage in the city.

Cardiovascular Risk Profile of Post-Menopausal Women in a Semi-Urban Community in Nigeria.

Aims: Menopause is associated with a myriad of chronic health risks. This study assessed the Cardiovascular Disease (CVD) risk profile of post-menopausal women from a semi-urban community in Nigeria. Study Design: Cross-sectional study Place and Duration of Study: Ife Central Local Government, Ile - Ife, Nigeria Methodology: One hundred and twenty menopausal women aged 55 years and older participated in this study. The respondents were recruited using a multistage sampling technique. The Framingham Heart Study Questionnaire was used to assess CVD risk level. Risk scores were classified as low (0-19), medium (20-29) and high risk (40+). Socio-Economic Status (SES) was assessed using a validated questionnaire while cardiovascular and anthropometric parameters were measured following standard procedures. Data were analyzed using descriptive and inferential statistics. Alpha level was set at 0.05. Results: The mean age, weight and Body Mass Index (BMI) of respondents were 64.9±8.4 years, 73.4±15.2kg and 27.3±5.4kg/m² respectively. A majority, 84(70.0%) of the respondents had high blood pressure, 77(64.2%) had over five years duration of onset of menopause while 13(10.8%) had high cardiovascular risk. Half of the respondents, 64(53.3%) were in the low SES class. High CVD risk was higher among individuals with over five years of menopause. Pearson Product Moment Correlation revealed significant relationship between CVD risk and each of age (r = 0.507; P = 0.01), body weight (r = 0.257; P = 0.01), onset time of menopause (0.359; P = 0.01), blood pressure status (r = 0.665; P = 0.01), occupation (r = 0.330; P = 0.01) and SES (r = 0.406; P = 0.01) among post-menopausal women. Conclusion: Prevalence of CVD risk was high among Nigerian post-menopausal women in a semi-urban community. Age, body weight, years of onset menopause, blood pressure, occupation and socio-economic status level had significant relationship with high cardiovascular disease risk.

Health care seeking behavior of urban and rural community in Ahmedabad district.

Background: Designing health care policies and programmes requires knowledge about health care seeking behaviour, so that appropriate interventions can be implemented. Health care seeking behaviour is influenced by the individual self, diseases, and the availability and accessibility of health services. Dependent on these determinants health care seeking behaviour is a complex outcome of many factors operating at various levels. Aims & Objective: Present study aimed at exploring possible differences in health care seeking behavior in rural and urban Ahmedabad. Material and Methods: A Cross-sectional study was carried out over a period of one year (April 2011-March 2012) in urban and rural area of Ahmedabad district. Total 500 houses from each were surveyed using pre-designed and pre-tested proforma by house to house visits. Head of the family from each household was interviewed. Information regarding morbidity and health seeking behaviour was collected during household survey. Results: Maximum number of respondents belonged to age group 25-39 years in urban (49.8%) and rural (53.8%). Rural people preferred government and trust hospitals (51.1%) more as compared to urban (44.1%). Significant difference was observed in place for treatment of acute illness from faith healers. More rural people (29.2%) took treatment from faith healers than urban (22.8%). Majority of rural people (59.6%) took treatment for chronic illness from private practitioner than urban (51.4%). More urban people (57.4%) were using cash savings for treatment than rural people while borrowing and selling assets for treatment was more in rural people (57.4%) The result was statistically significant. Insurance coverage for illness was significantly low both in urban and rural area. Conclusion: Difference in health seeking behaviour was noticed among urban and rural communities. As far as treatment of chronic illnesses is concerned more infrastructure investments should be made to improve accessibility to government health care facilities, especially in rural areas. There is a need to make the rural people more aware regarding availability of various health insurance schemes.

Investigation in the needs and satisfaction degree of EHR in the urban community of Jilin province / 中国实用护理杂志

Objective To understand the needs and satisfaction degree of EHR of the urban community residents in Jilin province in order to provide a realistic basis for the construction of community electronic health records.Methods A questionnaire survey was carried out among 191 Urban Community residents in 9 cities of Jilin province and the result of the investigation was analyzed statistically.Results The average scores of the community residents' needs on EHR were more than 3 points (the total score was 5 points); three positive items were accounting for the top three in the overall evaluation of EHR,so the satisfaction degree was good.Conclusions Improving community residents' satisfaction on EHR and establishing electronic health records according to the community residents' health service needs are of great significance in community health information construction.

Care management of non-communicable diseases in urban community.

In Thailand, non-communicable diseases are becoming increasingly more important problems than in the past. The government cannot afford to provide effective, health services for everyone, especially those in slums and blighted areas. There are several causes of these problems, and it is important to find ways to solve them. In a retrospective study of methods to improve treatment of non-communicable diseases in the urban community of Din Daeng in 1993, we found that a pilot project of home health care for the elderly be the Social Medicine Department, Rajavithi Hospital, Ministry of Public Health, could change the habits of non-communicable disease patients. For example, the rate of compliance of taking medication increased form 84.7% to 91.5%. A study of the treatment of diabetic and hypertensive patients in Din Daeng in 1998, showed that Rajavithi Hospital’s health teams and village health volunteers could change the habits of the patients such as improving compliance from 76.6% to 90% in diabetic patients and form 84.4% to 100% in hypertensive patients. Presently, the establishment of CPHCC, including many training activities for the volunteers the community to provide self health services in both urban and rural areas, is happening not only in Thailand, but also in other countries. This preliminary study may be an alternative way to help treat the patients with non-communicable disease. Certainly, we can achieve the goal of “Health for All by the Year 200”. Even though this retrospective study shows an effective method for improving care management of non0communicable diseases in the urban community, there may exist other effective methods. This calls for further studies.

Factors Related to Health Behaviors of the People in an Urban Community: Based on the Health Belief Model / 한국역학회지

Variables derived from the health belief model were studied in relation to practices of health behavior, which was measured in terms of thoroughness. Data were collected from the sample of 984 adults living in A-Gu of Pusan, during in-home interviews using structured questionnaires. Women practiced more health behaviors than men. The significant negative relationship was found between perceived barriers to health behavior and practices of health behavior in men and women. In addition, emotional support in men and perceived benefits of health behavior in women were also significant predictors of health behaviors. These findings suggest that in the study population, perceived barriers is the most powerful predictor for practices of health behavior and social support is also important for facilitating positive health behaviors.

An Investigation to the Diagnostic Validity of MMSE-K and the Psychopathology in a Group of Urban Patients with Dementia of Alzheimer Type / 신경정신의학

OBJECTIVES: The purpose of present study was to determine the validity of MMSE-K and its items in a group of urban patients with dementia of Alzheimer type and investigate the frequency of psychiatric symptoms and the correlation between the severity of cognitive impairment and that of psychopathology in them. METHODS: The subjects were 107 residents, aged over 55, of an urban community, who participated voluntarily in a free medical service for dementic patients. At first, MMSE-K were administered to all the participients to screen for the cognitive impairment. They were diagnosed mainly by the criteria of DSM-IV for dementia of Alzheimer type. Other diagnostic procedures were performed at that time and these included: a history taking for the past and present medical and psychiatric illnesses of the subject and its family members, physical and neurological examinations, clinical evaluations using several psychiatric symptom rating scales such as BPRS, HDRS, HARS and Overt Aggression Scale, Hachinski's Ishcemic Scale, evaluations for sleep disturbances and behavioral problems in daily living. The majority, of total 72 subjects who were evaluated as having cognitive dysfunctions, were the patients with dementia of Alzheimer type: 52 dementia of Alzheimer type, 12 vascular dementia, one mixed type of the two, and 7 others. We determined the validity of MMSE-K and its items in 52 subjects with dementia of Alzheimer type except the two, who could not respond well to the instructions of MMSE-K due to severe cognitive impairments, and 34 non-dementic subjects with only mild psychiatric symptoms. In 42 subjects with dementia of Alzheimer type who completed all the clinical rating scales with confidence, we investigated the frequency of psychiatric symptoms and the correlation between the severity of cognitive impairment and psychopathology. RESULTS: 1) The percent of false positive in diagnosing dementia of Alzheimer type using MMSE-K was 8.0%, and the sensitivity of MMSE-K was 82% in our 107 urban subjects. 2) There were statistically significant differences in the the mean scores of all items except the item, judgement, between the patients with dementia of Alzheimer type and non-dementic subjects(p<0.05). The two items, orientation for time and place, and the item, copy two pentagons, had the sensitivity and specificity over 70%. 3) The frequencies of behavioral and psychiatric symptoms in 42 patients with dementia of Alzheimer type were as follows: verbal aggression(50.0%), depression(46.2%), insomnia(30.8%), ...... , hallucination(21.2%) and delusion(15.4%). 4) The more cognitive dysfunctions had the patient with dementia of Alzheimer type, the more higher scores in the thinking disturbance subscale of BPRS they showed(p<0.01). CONCLUSION: MMSE-K was proved to be a valid instrument to evaluate the cognitive impairments in patients with dementia of Alzheimer type, but the item, judgement, newly admitted to MMSE-K instead of a language item in MMSE, was proved to be lack of power to discriminate the dementic patient from non-dementic subjects. Our subjects with dementia of Alzheimer type had revealed several behavioral and psychiatric symptoms other than cognitive dysfunctions, and those included depression, anxiety, insommnia, aggression, delusion and hallucination which needed intensive pharmacological interventions.

A Comparison Study on the Psychopathology between the Patients with Dementia of Alzheimer Type and Normal Controls in an Urban Community / 신경정신의학

OBJECT: There are lots of studies on the cognitive impairments in patients with dementia of Alzheimer type in our country, but those on the psychopathology in them are very scanty. We investigated the psychopathology such as psychotic symptoms, depression, and anxiety and their correlations with the severity of cognitive impairments in our urban subjects with dementia of Alzheimer type. METHODS: Our subjects(N=34) with dementia of Alzheimer type in an area of Pusan, aged over 65, are screened with MMSE-K(below 24) and Hachinski's Ischemic Scale(below 4) and enrolled in this study when they met with the criteria of dementia of DSM-IV. They were devided into the mild(N=16) and severe dementic group(N=18) according to their scores of MMSE-K(cut-off point 20/21). The severities of psychiatric symptoms in the two groups were evaluated by using sets of clinical symptom rating scales such as BPRS, HAM-D, and HAM-A and the frequencies of aggressive behaviors and sleep disturbances in them were also rated at that time by two psychiatrists. Data of the two dementic groups were compared with those of healthy control subjects(N=40). RESULTS: The mean total score of BPRS, scores of thinking disturbance and withdrawal retardation subscale were lowest in the healthy control group and highest in the severe dementic group(p<0.05). Mean score of anxious depression subscale of mild dementic group was higher than that of other two groups(p<0.05). There were no ststistical differences in the mean score of hostile suspiciousness subscale among the three groups. The mean total scores of HAM-D and HAM-A tended to be higher in mild dementic group than in other two groups, but the differences were not reached to the statistical significance. These findings were thought to be identical with those of following. The total frequency of insomnia only tended to be higher, but the frequency of initial insomnia and that of using hypnotics were highest in mild dementic group(p<0.05). The frequency of aggressive behaviors tended to be higher in mild dementic group than in other two groups, but the differences were not reached to the statistical significance. CONCLUSION: Patients with dementia of Alzheimer type suffered from several psychiatric problems such as psychotic symptoms, depression, anxiety, insomnia, and aggressive behaviors from the initial stage of the illness. Clinicians should be more aware of those symptoms which need proper pharmacological and social interventions, especially in patients with mild cognitive impairment.

A study on social help for the medical care of senior citizens with great financial difficulties(SCGFD) in Luwan District of Shanghai / 中华医院管理杂志

Supported by various departments concerned of the district government, medical workers in Luwan District of Shanghai started in 1994 to set up in the whole district community based social help network for the medical care of SCGFD. In the last 4 years, the annual outpatient volume of SCGFD averaged 3.9 times and the annual visits received by SCGFD averaged 2.2 times. The conditions of 78.1% of SCGFD suffering from an illness turned for the better or became stable. The annual hospitalization utilization ratio averaged 5.4%. After hospitalization, 89.5% of SCGFD suffering from a serious illness fully recovered from their illness or were discharged after turning for the better. The average outpatient expenses per time, hospitalization expenses per day and per time of SCGFD respectively dropped 32.1%, 21.5% and 30.4%, as compared with the group of senior citizens enjoying free medical care. The authors hold that the social help network for the medical care of SCGFD in Luwan District is an easy to operate and effective community based medical security system for SCGFD. It has produced sound social repercussions after being put into practice. The controlled use of medical funds has ensured the normal operation of the network.