Huge brown tumor of the rib in an unlocatable hyperparathyroidism patient with “self-recovered” serum calcium and parathyroid hormone: A case report

BACKGROUND The brown tumor is a kind of complication of hyperparathyroidism(HPT). The ultimate therapy usually is the resolution of HPT. We herein report an unlocatable HPT patient who received resection of a huge brown tumor of the rib, and experienced "self-recovery" of serum calcium and parathyroid hormone.CASE SUMMARY A 34-year-old female patient who suffered from a gradually increasing mass of the left chest wall since 2007 came to our hospital for treatment. The patient had a history of serum Ca and parathyroid hormone(PTH) increasing since June 2015 and received zoledronic acid treatment for 17 mo. When she came to our hospital in November 2017 after discontinuing medical treatment for 3 mo, the serum Ca and PTH levels were within normal ranges. The patient had no imaging abnormalities of parathyroid ultrasound or 99 m Tc-methoxyisobutyl isonitrile.Enhanced computed tomography revealed a local soft tissue mass of 96 mm × 113 mm with bone erosion of the left 8 th rib, and the mass presented irregular enhancement with an unclear boundary between the mass and spleen. The mass was thought to likely be caused by HPT, but a malignancy could not be ruled out.Resection of the mass was performed, and the pathology proved that the mass was a brown tumor. A diagnosis of unlocatable HPT was considered. Since the serum Ca and PTH levels were both normal pre-and post-operation, the patient did not receive exploratory surgery for HPT, and received regular follow-up.CONCLUSION The huge brown tumor of the rib and "self-recovered" serum PTH and Ca levels are relatively rare in HPT patients. An exploratory operation may be deferred for these patients, and long-term follow-up should be performed.

Technology Usage among Elderly with Self-Reported Hearing Disability: Results from InveCe.Ab

Background: Awareness of hearing disability in the elderly has adverse cognitive and functional consequences over time, in a longitudinal population-based study. Aim: To analyze the hypothesis that over time old people aware of hearing disability make less use of technology and lose more instrumental activities of daily living than peers with other self-reported hearing conditions. Methods: We analyzed 1171 healthy participants in the longitudinal population-based InveCe.Ab study. The consistency between self-reported hearing loss with clinician-evaluated hearing status (Whispered Voice Test;WVT), was categorized by consistency as: unaware of hearing loss (UHL), aware of hearing loss (AHL), only subjective hearing loss (OSHL), without hearing loss (noHL). Results: At baseline (2010), hearing loss was found in 159 [13.6% (95% CI: 11.7 - 15.7)] of the participants [28 = 17.6% (95% CI: 12.0 - 24.4) AHL;131 = 82.4% (95% CI: 75.6 - 88) UHL], while 23 [2.3% (95% CI: 1.4 - 3.4)] of the subjects with normal WVT had OSHL. Mobile phone usage was significantly associated with different consistency categories (p i.e. executive, memory and visuo-spatial) were independently associated with maintaining mobile phone usage and instrumental activities of daily living. Conclusion: Self-reported hearing disability is linked to subsequent loss of mobile phone usage and functional dependency. As cognitive performances independently influence technology usage and functional impairment, targeted preventive interventions should address functional impact of perceived hearing loss, but also encourage social participation and improve mobile phone usage. Trial registration: ClinicalTrials.gov, NCT01345110;registered on April 29, 2011.

Knowledge Level and Self-Reported Attitudes of Food Handlers: Case Study of a University Campus

This study was performed conducting surveys to assess the Knowledge Level (KL) and Self-Reported Attitudes (SRA) of Food Handlers (FH) in order to evaluate their food safety perception. Food handlers working in 5 cafes and 6 canteens in a university campus responded to a questionnaire about food hygiene. The knowledge level about food hygiene was obtained by answering five question groups (G): Agents involved in food borne diseases (G1), Food handling hygiene (G2), Cross contamination (G3), Heat treatment/cooling techniques (G4), Reduced temperatures (G5). The SRA level was obtained through seven questions with multiple choice options on behaviors of health and safety applied to the work routine, which were considered as percentage of hits. The hygiene’s knowledge average was 75%, ranging from 63.3% (G4) to 94.5% (G3). Significant associations between establishment type and G1 (p = 0.027), professional experience and G5 (p = 0.020), training and G5 (p = 0.037) were found. Food handlers knowledge did not have effect in FH attitude (p = 0.371). From 25 FH (46.0%) who had high KL, 17 had reported incorrect attitudes. The level of hits is, in general, more than 75%, except for matters relating to the use of different cutting tables (44.4%) and knives (51.9%). Significant differences of values and odds for handlers’ knowledge were observed between cafes’ and canteens’ FH. No difference (p > 0.05) was observed in FH SRA scores according to the type of establishment. The results reveal a reduced application of knowledge acquired by food handlers, evidenced by the low level of attitudes considered correct. This clearly justifies the implementation of additional measures, including on job training as part of an effective strategy to control establishment’s food safety.

What Is the Role of Work-Related Factors in Self-Reported Health Inequalities among Employed Individuals? A Longitudinal Study in Luxembourg

Objectives: We measured health inequalities among employed Luxembourg residents over time and the socio-economic and work-related determinants. Design and Setting: Longitudinal data were obtained from the Socio-economic Liewen zu Lëtzebuerg/European Union Survey on Income and Living Conditions, which has been conducted each year since 2003 in Luxembourg. Participants: Participants comprised 727 Luxembourg residents (58% men), aged between 21 and 55 years in 2003, who were employed between 2003 and 2012. Primary and Secondary Outcomes Measured: The variable of interest was self-reported health. We used transition indicators on work-related factors to consider changes that individuals may have experienced in their job over this period. Results: People who moved from a part-time to a full-time contract (odds ratio (OR): 5.52, confidence interval (CI): 1.55 - 19.73), and those who moved from the 3rd or 4th quartile of earnings to the 1st or 2nd quartile (OR: 2.48, CI: 1.02 - 6.05) between 2003 and 2012, had a higher risk of being in poor health in 2012. The risk of deterioration in self-reported health in 2012 among people who were healthy in 2003 was associated with the type of contract, economic activity, and occupation. Conclusion: Health inequalities occur among employed people in Luxembourg. Their importance varies according to work-related characteristics and economic activity. Our findings showed that declined health status was associated with contract type, profession, and economic activity. This suggests that measures should be taken to maintain good health for people working in these specific occupations or economic sectors (e.g. preventive action, reduction of risk exposure, change of occupation in the same company, and so on).

Self-Reporting of Adverse Drug Reactions in Iraqi Hospitals: Patient’s Perspectives

Background: Adverse drug reactions (ADRs) represent the important cause of morbidity and mortality that affect patients using drugs. Previous studies have clarified the knowledge and attitude toward ADRs reporting among healthcare providers, while studies toward awareness of patients are limited. Aim and Objective: To evaluate knowledge and attitude toward ADRs reporting among patients visiting general hospitals in Baghdad City. Methods: This observational study was conducted on randomly selected 300 patients at the out-patient setting of general hospitals in Baghdad. Demographic characteristics of participants were documented and questionnaire regarding knowledge and perceptions was given to fill up, and the data were analyzed using descriptive statistics. Results: Demographic analysis showed that 55% of patients were males, 62% of them were from rural areas, and only 34% were college graduates. Regarding knowledge about ADRs, 73.3% patients were aware about ADRs and 37% had experienced ADRs in past. None of the respondents were aware of ADR reporting center. Regarding perceptions toward ADR, 84.2% agreed to report ADR in future and 90% respondents believed that ADR reporting may strengthen the patient safety. According to 61% of patients, patient education program is the best way to educate them regarding ADR. Conclusion: Educational interventions are highly recommended to improve awareness among patients regarding the validity of ADRs reporting.

Correlates of self-reported colorectal cancer screening accuracy in a multi-specialty medical group practice

Purpose: We assessed whether accuracy of self-reported screening for colorectal cancer (CRC) varied by respondent characteristics or healthcare utilization. Methods: From 2005 to 2007, 857 respondents aged 51 - 74 were recruited from a multi-specialty medical group practice to answer a questionnaire about their CRC screening (CRCS) behaviors. Self-reports were compared with administrative and medical records to assess concordance, sensitivity, specificity, and report-to-records ratios for overall CRCS (fecal occult blood test, sigmoidoscopy, and/or colonoscopy). Results: Concordance was good (30.8 to 30.7 to 5 visits outside the clinic had poor (30.9) or good but poor for respondents whose healthcare provider did not advise a specific CRCS test. Specificity was poor for the following respondents: 65+ years, males, college graduates, family history of CRC, >5 visits outside of the clinic, or whose healthcare provider advised a specific CRCS test. Respondents 65+ years and with >5 outside visits over-reported CRCS. Conclusions: With few exceptions, self-reports of CRCS in an insured population is reasonably accurate across subgroups. More work is needed to replicate these findings in diverse settings and populations to better understand subgroup differences and improve measures of CRCS.

Self-reported cigarette smoking status imprecisely quantifies exposure in pregnancy

Objective: We sought to determine the validity of self-reported smoking activity versus two quantitative measurements of tobacco exposure in pregnancy. We hypothesized that pregnant women would under-report their daily smoking amounts, due to the negative social stigmas associated with such a behavior. Methods: Cigarette-smoking and non-smoking pregnant women were recruited as part of a larger research study. Pregnant women with a singleton baby (>24 weeks) were recruited at a clinical appointment or prior to an elective caesarian section. Self-reported smoking status, including time since last cigarette, was recorded. End-tidal breath carbon monoxide (ETCO) levels and urine cotinine levels were measured and compared. Results: Both normotensive non-smoking (NTN) (n = 44) and normotensive smoking (NTS) (n = 24) pregnant women were recruited. A strong correlation was found between ETCO levels and urine cotinine measurements (r = 0.6566, p 0.05). Conclusion: Self-reported smoking status accurately identifies women who smoke in pregnancy, but not their level of tobacco exposure. Urine cotinine or ETCO are much better quantitative measurements of nicotine and carbon monoxide, respectively, and should be measured for a more precise indicator of smoking activity. These devices will allow for better counseling and monitoring of women who are trying to quit smoking and/or who enter into smoking cessation programs.

The Influence of Social Desirability on Self-Reported Sexual Behavior in HIV Survey in Rural Ethiopia

Objective: It is in order to examine associations between social desirability (SD) and self-reports of abstinence among youths in rural Ethiopia. Methods: Youths of ages 15-24 (114 participants) were administered questionnaire to assess HIV knowledge and primary abstinence and a modified Marlowe-Crowne Social Desirability Scale to assess SD bias. The relationships between SD groups (dichotomized into high and low) and abstinence by various characteristics were assessed by using Fisher’s exact p-values. Results: The odds of individuals reporting abstinence were 13.2 times greater in the high SD group compared to the low SD group (p-value 0.002) when adjusted for education, gender, age group, and HIV knowledge. The differences in abstinence between the high and low SD score groups were also examined for selected variables. Conclusions: Individuals who exhibited more SD bias were more likely to report primary abstinence. SD bias should be considered when conducting self-reported surveys to measure the effectiveness of HIV prevention programs.

Accuracy of self-reported medicines use compared to pharmaceutical claims data amongst a national sample of older Australian women

This study assessed agreement between two measures of medicine use, self-report by mail and pharmaceutical claims data, for a national sample (N = 4687) of older women aged 79 to84 in2005, from the Australian Longitudinal Study on Women’s Health. Medicines used for common chronic diseases in older people were selected, with pharmaceutical claims data retrieval periods of three and six months. For six month retrieval, Kappa’s ranged between 0.44 (nervous system medicines) and 0.94 (glucose lowering medicines). For three month retrieval, aspirin (Kappa: 0.35) and folic acid (Kappa = 0.48) had lowest agreement. Women were least able to accurately report use of nervous system medicines (sensitivity 80%). Specificity was consistently high across all classes, suggesting women could accurately report using a medicine. Pharmaceutical claims data can assist evaluation of judicious medicines use, changes to availability and uptake of medicines, and track medicine expenditure for chronic conditions. Over-the-counter medicines, medicines not covered by pharmaceutical subsidies and those used on an as needed basis may be best measured by self-report, as use may be underestimated using pharmaceutical claims data.

Acne Vulgaris in Jeddah Medical Students: Prevalence, Severity, Self-Report, and Treatment Practices

Acne is a common skin disorder of teenagers and continues into adulthood. Research has been limited regarding acne prevalence, perception and health care utilization in Saudi Arabia. The objective of this study was to assess acne prevalence in final year female medical students in Jeddah, Saudi Arabia using the global acne grading system (GAGS) compared with student’s self-report of their acne. This is a cross-sectional study conducted among 151 students during 2016, in which students were interviewed subjectively and examined objectively by a trained physician. This study showed that acne was reported subjectively by 83.4% of female students compared to 98% of students assessed objectively by the global acne grading system. 14.6% of students claimed having no acne while it was objectively present, which was statistically significant (Χ2 = 15.4, P 2 months in 39.1% of students. Acne was present in 41.1% of the students parents compared to 83.4% in their siblings. A total of 41.7% of student had trunk acne. 60.9% of students had scarring and 72.8% of them had pigmentation. Moderate to severe acne students had higher siblings acne history of 95.2% (Χ2 = 5.85, P 2 = 4.05, P 2 = 4.87, P < 0.05) which was statistically significant. Our study confirms that acne is very common in female medical students in Jeddah, Saudi Arabia with a prevalence rate of 98%. Knowledge regarding acne treatment was inadequate demonstrating the need for educational and awareness programs about early treatment that will prevent suffering from acne scarring or pigmentation.

刑事合规的制度价值及其实现路径

通过制度史的考察不难发现,刑事合规制度具有三个方面的价值,即作为直接目的的效率价值、作为终极目的的预防价值以及通过替代性惩罚实现的报应价值。以这三方面的制度价值为线索,梳理我国的涉案企业合规改革试点不难发现,预防价值受到“广泛不起诉”“专项合规”“合规监督考察形式化”等方面的多重折损,以自我报告为核心抓手的效率价值未受到重视,替代性惩罚严重弱化。结合我国的制度现实,未来应当重视合规制度的预防价值,也不能忽视效率价值以及通过替代性惩罚实现的报应价值。为了提升制度的预防价值,需要警惕对涉案企业及个人处罚的过度轻缓化和合规整改的形式化;为了提升制度的效率价值,认罪认罚应当是制度适用前提,同时提升自我报告在程序选择中的意义;为了强化制度的报应价值,即便认可合规互认机制,也应当保持在适当限度。

中国健康的代际流动性

使用2010—2020年中国家庭追踪调查数据,构建具有质量调整生命年形式的自评健康连续变量,估计中国健康的代际流动性。研究发现:健康的代际传递程度相对较低,代际流动性较高,健康的代际秩回归系数为0.208。同性别的父代与子代间表现出更强的健康继承性,其中母女的健康关联最为紧密。健康的代际流动性在时间维度上表现出递增的变动趋势,但衰减偏误和生命周期偏误在一定程度上会扭曲对代际健康流动的估计。基于Gelbach方法的分解发现,母亲健康对代际健康传递具有更高的贡献率。中国代际福利流动性处于较高水平,福利的代际秩回归系数为0.172。研究结果为持续有效地实施健康中国战略提供了定量政策参考。

针对患者自我报告症状的护理干预在乳腺癌根治术患者中的应用效果

目的探讨基于患者自我报告症状的护理方案干预措施在乳腺癌根治术患者中的应用效果。方法选取2021年6月—2022年6月医院收治的乳腺癌根治手术患者92例为研究对象,按基本资料具有可比性的原则将患者分为观察组和对照组各46例,对照组围手术期行常规性护理,观察组围手术期实施基于患者自我报告症状的护理方案,记录两组相关症状发生率、症状持续时间,比较两组干预前后症状严重程度评分及患者生活质量改善情况。结果观察组术后疼痛、疲乏、焦虑、睡眠障碍、患肢水肿等发生率依次为13.04%、17.39%、10.87%、10.87%、8.69%,对照组相关症状发生率依次为39.13%、56.52%、54.35%、47.83%、52.17%,组间比较差异有统计学意义(P<0.05)。观察组疼痛、睡眠障碍、疲乏、肢体水肿、焦虑等症状持续时间依次为2.02±0.32 d、2.63±0.38 d、2.22±0.42 d、2.85±1.21 d、2.63±0.63d,对照组相关症状持续时间依次为4.92±0.42 d、4.89±0.86 d、4.33±0.86 d、4.52±0.85 d、5.02±0.85d,两组相关症状持续时间比较差异有统计学意义(P<0.05)。干预后观察组乳腺癌生存质量评定量表(FACT-B)总评分为120.49±6.97分,对照组FACT-B总评分为98.30±5.78分,差异有统计学意义(P<0.05)。结论基于患者自我报告症状的护理方案能有效减少乳腺癌根治术患者术后不良症状发生率及持续时间,有助于患者功能状态恢复,提高患者生活质量。

新医改背景下医共体内护士心理状况调查

目的 研究新医改背景下医共体内护士的心理状况。方法 选取2019年10月—2022年10月杭州市萧山区医共体单位内295名护士为调查对象,对其一般资料、工作情况行调查统计,使用症状自评量表(self-reporting inventory-90,SCL-90)、一般自我效能感量表(general self-efficacy scale,GSES)对其心理健康和自我效能进行评估。结果 工作日平均工作时间>10h护士的SCL-90评分为(164.50±67.35)分,高于> 8~10h、≤8 h护士的(147.61±53.70)、(134.45±40.19)分,差异有统计学意义(P<0.05)。年龄> 40岁护士的GESE评分高于> 30~40岁、21~30岁护士,差异有统计学意义(P<0.05)。三级医院护士的GESE评分高于二级医院、一级医院,差异有统计学意义(P<0.05)。工作时间> 30年、> 20~30年、> 10~20年护士的GESE评分高于> 5~10年、≤5年护士,差异有统计学意义(P<0.05)。工作日平均工作时间≤8 h护士的GESE评分高于> 8~10 h、>10h护士,差异有统计学意义(P<0.05)。结论 医共体内部分护士心理健康问题较为严重,自我效能感处于中等水平,应合理调整护士工作日平均工作时间以提高护士自我效能感、改善护士心理健康。

竞技运动中的认知负荷评估

科学评估训练负荷是优化运动表现、预防运动伤害的关键。目前的研究主要关注的是机械和生理方面,对认知方面的关注明显不足。认知负荷在调节运动表现中的作用已得到广泛认可,但有关认知负荷的评估目前还存在诸多困难和障碍,缺乏适当的评估方法是造成这一现象的主因。笔者运用文献资料法、专家访谈法和逻辑分析法,对竞技运动中的认知负荷评估进行了探讨。研究结果显示:竞技运动中的认知负荷评估可以借助自我报告方法、行为测量方法和生理测量方法进行,但要提高评估的有效性,通常需要整合运用多种主观和客观的方法和技术。

医疗器械检验报告审核和质量管理探讨

目的:医疗器械具有复杂性、特殊性、专业性、涉及门类广等特点,面对医疗器械开放自检及检验市场竞争日益加剧的形势,如何提升检验能力,适应产业的迅速发展,确保检验结果的科学性、公正性、权威性,是各医疗器械检验机构面临的共同挑战。方法:从医疗器械检验面临的挑战、法律法规要求、质量管理体系关注要点等方面进行阐述。结果:通过对报告审核中发现的问题,提出质量改进措施及建议。结论:医疗器械检验机构应持续提升检验能力,发展特色优势领域,积极应对医疗器械快速发展的需要及检验新形势,提质增效,应在医疗器械的质量检验工作中,引入风险管理理念并加强过程控制,从人、机、料、法、环等方面构建起全方位的保障体系,提高检验质量和效率,助力医疗器械高质量发展。

简版儿科症状筛查工具的汉化及在4~7岁癌症患儿中的信效度检验

目的汉化简版儿科症状筛查工具,并在4~7岁癌症患儿中检验信效度。方法获得原作者授权后,采用Brislin翻译模型通过翻译、回译、跨文化调适和预调查形成中文版简版儿科症状筛查工具。2022年12月—2023年5月,采用便利抽样法,选取广州市2所三级甲等医院住院的210例4~7岁癌症患儿进行问卷调查,以检验中文版量表的信效度。结果中文版简版儿科症状筛查工具为单维度量表,包括15个常见症状条目和1个开放性问题,量表的条目水平内容效度指数及平均量表水平内容效度指数均为1.000。验证性因子分析显示模型拟合结果良好。总量表Cronbachα系数为0.843,折半系数为0.829。结论中文版简版儿科症状筛查工具在4~7岁癌症患儿中具有较好的信效度,可作为评估该年龄癌症患儿症状困扰程度的工具。

平衡训练对慢性踝关节不稳影响效果的Meta分析

目的:慢性踝关节不稳临床上主要表现为肌无力、间断性疼痛和反复崴脚等症状,严重影响运动锻炼和日常生活。本体感觉缺失、腓骨反应时间延长和外翻力量减弱等可能是造成慢性踝关节不稳的主要原因,因此通过运动干预可以有效改善踝关节不稳相关症状。通过Meta分析定量评价平衡训练对慢性踝关节不稳康复干预的效果,为慢性踝关节不稳患者科学制定运动处方提供可靠的理论基础和实践依据。方法:检索中国知网、维普、Web of Science和PubMed数据库关于平衡训练对慢性踝关节不稳患者症状康复和动态平衡影响的随机对照试验文献,文献发表时间为各数据库建库至2022-11-23。包括2名评审人员依据物理治疗证据量表对纳入文献进行文献质量评估,主要结局指标为自我功能评分量表,次要结局指标为星形偏移平衡测试,均为连续性变量。采用RevMan 5.3和Stata-SE 15软件对纳入文献进行森林图绘制、Meta回归、亚组分析、敏感性分析和发表偏倚评价。结果:①共纳入18篇随机对照试验文献,包括慢性踝关节不稳患者641例。整体上文献的方法学质量较高。②Meta分析结果显示,平衡训练可以改善慢性踝关节不稳患者的功能康复效果(SMD=0.82,95%CI:0.41-1.23,P<0.0001)。Meta回归显示干预时间可能是产生异质性的主要原因(P=0.008)。③亚组分析结果显示,干预6周(SMD=0.98,95%CI:0.31-1.65,P=0.03)、每周干预大于3次(SMD=0.87,95%CI:0.30-1.44,P=0.003)和每次干预时间小于20 min(SMD=0.89,95%CI:0.61-1.66,P<0.0001)是改善慢性踝关节不稳患者功能康复效果的最佳康复方案。④Meta分析结果还显示,平衡训练可以改善星形偏移平衡测试前侧(SMD=0.56,95%CI:0.31-0.80,P<0.05)、后内侧(SMD=0.88,95%CI:0.45-1.32,P<0.05)和后外侧(SMD=0.84,95%CI:0.22-1.46,P<0.05)伸展程度。结论:当前临床证据表明,平衡训练可以改善慢性踝关节不稳患者的踝关节不稳功能症状和提高动态平衡能力,建议通过每周干预大于3次,每次干预小于20 min的干预时间以获得更好的康复效果。

6~36月龄婴幼儿膳食多样性与自报患病的相关性分析

目的:探究中国10城市6~36月龄婴幼儿膳食多样性与自报患病情况的相关性。方法:基于2019—2020年在中国10城市开展的横断面调查的数据,通过问卷收集婴幼儿的相关人口学特征、自报患病情况及膳食多样性情况,使用卡方检验、Logistic回归、负二项回归模型分析婴幼儿膳食多样性与自报患病发生率及患病次数之间的相关性。结果:我国城市婴幼儿最低膳食多样性满足率为74.6%,婴幼儿年龄越大、家庭人均月收入越高、父亲教育程度越高其最低膳食多样性满足率更高(P<0.05)。满足最低膳食多样性的婴幼儿其呼吸系统疾病(IRR=0.76,95%CI:0.58~0.98,P=0.035)以及腹泻(IRR=0.65,95%CI:0.48~0.88,P=0.006)发生的次数更低。暂未发现婴幼儿膳食多样性与各自报疾病的发生率之间存在显著相关关系。结论:中国城市6~36月龄婴幼儿膳食多样性与呼吸系统疾病以及腹泻存在一定关联。

居住安排对老年人自评生活质量的影响:基于“状态——变化”的分析视角

文章使用2008—2018年中国老年健康影响因素跟踪调查的四期面板数据,利用时间固定效应模型,分析不同居住安排状态及其变化对老年人自评生活质量产生的影响。研究发现,相较于独居老年人,与他人同住的老年人自评生活质量更高,而在各同住情形中,仅与子女同住的老年人自评生活质量最高。居住安排变化同样会影响老年人自评生活质量,相较于始终同住的老年人,始终独居与先同住后独居的老年人自评生活质量通常会更低,但先独居后同住却并不会对其自评生活质量产生显著影响。基于此,为进一步提高老年人的整体生活质量,文章认为应重点加强对空巢、独居老年人的生活关照,同时努力为老年人营造出舒适且稳定的居住条件。