According to news from the website of National Health and Family Planning Commission(NHFPC)on April 17,Ministry of Finance and NHFPC recently issued Opinions on Further Improving the Input Mechanism in Family Planning,
This research focuses on the impact of family's human capital on social mobility in China's rural community.Empirical research is conducted based on data from surveying a typical rural community in the past 20 yr.Th...This research focuses on the impact of family's human capital on social mobility in China's rural community.Empirical research is conducted based on data from surveying a typical rural community in the past 20 yr.The study indicates that social mobility in rural area is active in the past 20 yr,and the human capital of family,represented by primary labor's education level,has played an essential role in mobility of low social class.Meanwhile,socio-economic development and the change of supply and demand in labor market dims the signaling role of degree education,but the impact of occupational training is increasingly remarkable.Therefore,the change from sole degree education to multi-leveled education including occupational education and training is a main way for China's rural families in low class to realize social mobility.展开更多
In recent years, the rural family farms in Shandong Province of China have been developing very fast. They have achieved remarkable economic effects on improving the technical and equipment level of agricultural produ...In recent years, the rural family farms in Shandong Province of China have been developing very fast. They have achieved remarkable economic effects on improving the technical and equipment level of agricultural production, farmers’ professional quality, the efficiency of land production and farmers’ income-increase, etc. However, there also exist the problems of non-smooth land transfer, unclear farm recognition-standard, more difficult loan-financing, imperfect social service and so on. This paper suggests that measures should be taken to deepen the reform of the rural land system, perfect the land transfer mechanism, clarify the family farms confirmed standards, improve the family farms and financing system, perfect the socialized service system, and thus create a relaxed environment and conditions for the development of family farms in order to promote its healthy development.展开更多
This article uses data from censuses since 1982 to reveal changes in the family structure of rural China since the launch of reform and opening up and against the backdrop of institutional relocation,social transforma...This article uses data from censuses since 1982 to reveal changes in the family structure of rural China since the launch of reform and opening up and against the backdrop of institutional relocation,social transformation and an aging population.Since the advent of reform and opening up,rural family structure and its changes can be divided into two phases.Before the 1990 s,the household contract responsibility system was implemented,labor in rural villages was still mainly engaged in farming,and the number of nuclear families remained stable with a steady rise.After the 1990 s,as reform progress deepened,substantial numbers of young and middle-aged laborers in rural villages began to relocate into non-farming sectors and aging in rural villages rose.As those born in the early days of the family planning policy gradually matured,family structure was directly affected and changed in new ways and forms not seen before.Vocational divisions of labor among the parents of young families and married offspring emerged and the significance of cooperation for family economy and daily life between parents and offspring rose in importance.Also,the prevalence of immediate families with three generations climbed while the standard nuclear families declined,the ratio of middle-aged couples with young children that worked outside the home increased,the function of middle-aged and senior parents in the upbringing of infants and children enhanced,and the commonness of incomplete family types such as only grandparents with grandchildren increased.During this phase,the number of seniors living alone surged to the point of becoming a matter worthy of attention.展开更多
Under the pressure of marketization and urbanization,rural family reproduction mode has transformed from simple reproduction to expanded family reproduction,thus changing the family structure and family relationship.U...Under the pressure of marketization and urbanization,rural family reproduction mode has transformed from simple reproduction to expanded family reproduction,thus changing the family structure and family relationship.Under the mode of expanded family reproduction,family relationship is a highly rational and deeply mobilized interaction pattern.And the family element configuration profoundly reflects the practical form of family relationship.Under the mode of expanded family reproduction,the changes in rural family relations are mainly reflected in three aspects:the decline of the paternal authority and the increasing family status of the offspring;the increasing status of women along with a decisive role in family decision-making;the more independent,equal,competitive and rational relationship among brothers.These changes bring forward new requirements on rural governance system,which requires improvements on social security and public culture.展开更多
At first,this article gives an overview of previous researches on family migration,the pulling force and drag force of the rural residents' behavior of going out. On the basis of questionnaire survey of rural woma...At first,this article gives an overview of previous researches on family migration,the pulling force and drag force of the rural residents' behavior of going out. On the basis of questionnaire survey of rural woman's behavior of going out in Anhui Province,conducted in early 2011,this article studies the pulling force and drag force of rural woman's behavior of going out,their will to settle in the city,and the obstacles to settlement. Finally,I derive three pulling forces of rural woman's behavior of going out,and three major factors influencing settlement in city.展开更多
Taking 20 relative poor families in Hechuan District of Chongqing Municipality as survey samples,taking 275 households of rural families selected by stratified sampling method as research objects,and taking family edu...Taking 20 relative poor families in Hechuan District of Chongqing Municipality as survey samples,taking 275 households of rural families selected by stratified sampling method as research objects,and taking family education investment behavior of this rural area as research content,this paper studied current situations of rural family education investment behavior in Hechuan District,difference in investment behavior and related influence factors. It is intended to provide references for family education investment of rural areas in Hechuan District and even Chongqing Municipality,and promote development of rural education undertaking in China.展开更多
Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additiona...Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additional disparities regarding health care access, job availability, and daily living resources. Hence, the family impact of having a child with asthma may be influenced by geographic locale. This impact could be a result of health insurance tied to employment, out of pocket costs, and health care provider availability. Few studies have assessed the impact a child’s asthma has on a family. This study sought to answer the question: What is the impact of children with asthma on US rural families? Methods: Multivariate techniques were performed to examine a single year of data from two connected population-based datasets, the 2007-2008 National Survey of Children’s Health and the 2009-2010 Children with Special Health Care Needs Survey. Children with current asthma defined the study population for both datasets. A logistic regression model was performed for each database. The dependent variable for the first model was child in family currently has asthma, for the second it was rural children with current asthma. Results: The first logistic regression model confirmed that rural children were more likely to have asthma than non-rural children. The second logistic regression model yielded that rural families with a child diagnosed with asthma had greater odds of: not having health insurance, having a parent who stopped working, avoided a job change, or experienced financial problems because of the child’s health. Conclusions: This study demonstrated that rural families experience a disproportionate financial hardship as a result of their child’s asthma. Pharmacist intervention in asthma care in rural areas has the potential to decrease the financial burden for a family while also improving a child’s health.展开更多
To promote coordinated population and socioeconomic development in rural areas and alleviate special difficulties confronting rural households that practice family planning, and have only one child or two female child...To promote coordinated population and socioeconomic development in rural areas and alleviate special difficulties confronting rural households that practice family planning, and have only one child or two female children, we have formulated this plan in line with the Opinions of the National Population and Family Planning Commission and the Ministry of Finance on Piloting Work for Rewarding and Assisting Selected Rural Households That Practice Family Planning, as forwarded by the State Council General Office.展开更多
In order to solve the practical difficulties of rural households practicing family planning, further implement the population and family planning program and promote the establishment of coordinated and harmonious com...In order to solve the practical difficulties of rural households practicing family planning, further implement the population and family planning program and promote the establishment of coordinated and harmonious communities in rural areas,the central government launched a pilot project to reward and support rural families practicing family planning in five western provinces and ten cities in 2004. In 2005, the pilot sites were expanded to 23 more provinces and parts of Shandong and Tibet.展开更多
Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze...Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.展开更多
With the implementation of the policy of popularization of education, rural families make the choice of interests and behavior decisions through the calculation of their own benefits and costs, and gradually become th...With the implementation of the policy of popularization of education, rural families make the choice of interests and behavior decisions through the calculation of their own benefits and costs, and gradually become the main body of rural education investment decisions. The relationship between educational cost and income plays a major role in the rural family education investment. Based on the current situation of rural education in our country, this paper focuses on the risk of rural education investment and rural education costs and benefits, and then puts forward scientific, operational measures and suggestions.展开更多
However, with the development of economy and the aging of the population, this kind of old-age model is facing many problems, and the family pension function is weakened gradually. Therefore, based on this, the old-ag...However, with the development of economy and the aging of the population, this kind of old-age model is facing many problems, and the family pension function is weakened gradually. Therefore, based on this, the old-age pension system is still in the family. The situation of China's rural old-age security research has important practical significance.展开更多
In order to provide a policy basis for improving the early development of poor rural children,this paper uses quantitative data and quantitative research methods to study the early development of children in poor rura...In order to provide a policy basis for improving the early development of poor rural children,this paper uses quantitative data and quantitative research methods to study the early development of children in poor rural areas and the impact of family environmental quality on such development. The results show that the early development of poor rural children,especially the ability of social emotion is not perfect,and the quality of family environment has a significant impact on the early development of poor rural children. Therefore,in order to improve the early development of rural children,it is necessary to attach importance to the improvement of family environment and increase the interaction with children. The government needs to establish and improve the mechanism of providing early development services,increase investment and find more efficient service model.展开更多
With our country’s social development,the gap between urban and rural education has become increasingly obvious,especially the difference in student achievement.This study aims to explore the impact of the urban-rura...With our country’s social development,the gap between urban and rural education has become increasingly obvious,especially the difference in student achievement.This study aims to explore the impact of the urban-rural education gap on student achievement.The study adopts a quantitative analysis method to collect and analyze the academic performance,learning resources,and social resources of urban and rural students.The results show that the unbalanced distribution of educational resources in urban and rural areas is the key factor leading to the gap in students’achievement.For example,urban education resources are abundant while rural education resources are relatively scarce.At the same time,the difference in social environment and family economic status also have a significant impact on student achievement.The differences between urban and rural areas,particularly in terms of family economic conditions and their ability to invest in education,further widen the gap between urban and rural education.The results of this study can provide a reference for reducing the gap between urban and rural education and improving the academic performance of rural students.A fair education policy is essential to narrow the gap between urban and rural education resources distribution,so as to improve the equality of education in society.展开更多
背景高血压是心血管疾病主要的危险因素,降压用药不仅要考虑患者血压特征,也要考虑患者合并症情况。现阶段,基于家庭医生签约服务对高血压患者的服药状况及影响因素研究比较缺乏。目的调查安徽省界首市家庭医生签约服务的高血压患者服...背景高血压是心血管疾病主要的危险因素,降压用药不仅要考虑患者血压特征,也要考虑患者合并症情况。现阶段,基于家庭医生签约服务对高血压患者的服药状况及影响因素研究比较缺乏。目的调查安徽省界首市家庭医生签约服务的高血压患者服药现状,描述患者服药行为与患者特征之间的关联,探索患者用药调整的影响因素,并分析基层高血压患者用药的合理性。方法采用整群抽样的方法,于2021年7—8月从安徽省界首市随机抽取48个行政村,通过面对面调查法采用自制问卷收集患者特征和服药数据,参照《国家基层高血压防治管理指南2020版》将问卷中患者提到的降压药分为如下5类:A类为血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB),B类为β受体阻滞剂,C类为钙通道阻滞剂(CCB),D类为利尿剂,E类为单片复方制剂。通过科大讯飞智能语音血压计的后台获取患者上传的近1年血压数据,分析不同特征患者的服药行为。采用多因素Logistic回归分析探讨高血压患者用药调整的影响因素。本研究中联合用药是指服用复方制剂或2种以上降压药,用药调整是指患者过去服用其他降压药。结果本研究共纳入高血压患者3005例,其中男1291例(43.0%)、女1714例(57.0%),平均年龄为(65.5±9.8)岁,高血压服药率为79.1%,联合用药率为40.2%。2376例服用降压药的患者中,不同类型降压药服用率从高到低依次为(部分患者存在联合用药):E类(39.6%)、C类(35.1%)、D类(20.3%)、A类(20.1%)、B类(3.7%);服用最多的降压药为复方利血平(33.7%)。对于年均血压≥160/100mm Hg的患者,仍有12.2%和4.9%未服用降压药。患者联合用药以E类降压药为主。年均“舒张压≥100 mm Hg”且“患合并症”的患者,调整后A类和C类降压药的服用率增加相对较多,年均“收缩压≥160 mm Hg”且“未患合并症”的患者,调整后E类降压药的服用率增加相对较多。多因素Logistic回归结果显示,服药年数长(OR=1.042,95%CI=1.031~1.053,P<0.001)、初中以上文化程度(OR=1.488,95%CI=1.195~1.853,P<0.001)、合并高脂血症(OR=1.267,95%CI=1.052~1.525,P=0.013)、合并心血管疾病(OR=1.394,95%CI=1.166~1.667,P<0.001)、合并脑血管疾病(OR=1.258,95%CI=1.040~1.522,P=0.018)是患者用药调整的促进因素,高龄(OR=0.980,95%CI=0.971~0.990,P<0.001)是用药调整的抑制因素。结论界首市农村地区高血压患者的服药率较高,主要服用E类和C类降压药。服药年数长、初中以上文化程度、合并高脂血症、合并心脑血管疾病是患者用药调整的促进因素,高龄是用药调整的抑制因素。展开更多
背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有...背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有效性提供参考依据。方法于2023年1—4月,遵循范围综述报告规范清单,于Web of Science、PubMed、Embase、Medline、CINAHL、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库检索有关家庭医生签约服务老年人健康管理的文献,检索时限为建库至2022-12-31。根据纳入和排除标准,基于社会生态学模型审查、总结和分析影响农村家庭医生签约服务老年人健康管理实践的因素。结果共纳入27篇文献,提取了与农村家庭医生签约服务老年人健康管理相关的个人、人际、组织、社区及政策5个层面的影响因素。结论农村家庭医生签约服务老年人健康管理实践受到多层面、多因素影响,推动农村地区签约服务老年人健康管理发展需综合考虑其影响因素,明确各责任部门、主体的权利和义务,合力促进以家庭医生签约服务为载体的健康管理服务提质增效。展开更多
文摘According to news from the website of National Health and Family Planning Commission(NHFPC)on April 17,Ministry of Finance and NHFPC recently issued Opinions on Further Improving the Input Mechanism in Family Planning,
基金the Youth Project (2012) "Elements of Discrimination, economic the Overflow and Sustainable Growth" (71203129)the National Natural Science Foundation of China and Shanghai Education Science 2012 (B12019)
文摘This research focuses on the impact of family's human capital on social mobility in China's rural community.Empirical research is conducted based on data from surveying a typical rural community in the past 20 yr.The study indicates that social mobility in rural area is active in the past 20 yr,and the human capital of family,represented by primary labor's education level,has played an essential role in mobility of low social class.Meanwhile,socio-economic development and the change of supply and demand in labor market dims the signaling role of degree education,but the impact of occupational training is increasingly remarkable.Therefore,the change from sole degree education to multi-leveled education including occupational education and training is a main way for China's rural families in low class to realize social mobility.
文摘In recent years, the rural family farms in Shandong Province of China have been developing very fast. They have achieved remarkable economic effects on improving the technical and equipment level of agricultural production, farmers’ professional quality, the efficiency of land production and farmers’ income-increase, etc. However, there also exist the problems of non-smooth land transfer, unclear farm recognition-standard, more difficult loan-financing, imperfect social service and so on. This paper suggests that measures should be taken to deepen the reform of the rural land system, perfect the land transfer mechanism, clarify the family farms confirmed standards, improve the family farms and financing system, perfect the socialized service system, and thus create a relaxed environment and conditions for the development of family farms in order to promote its healthy development.
文摘This article uses data from censuses since 1982 to reveal changes in the family structure of rural China since the launch of reform and opening up and against the backdrop of institutional relocation,social transformation and an aging population.Since the advent of reform and opening up,rural family structure and its changes can be divided into two phases.Before the 1990 s,the household contract responsibility system was implemented,labor in rural villages was still mainly engaged in farming,and the number of nuclear families remained stable with a steady rise.After the 1990 s,as reform progress deepened,substantial numbers of young and middle-aged laborers in rural villages began to relocate into non-farming sectors and aging in rural villages rose.As those born in the early days of the family planning policy gradually matured,family structure was directly affected and changed in new ways and forms not seen before.Vocational divisions of labor among the parents of young families and married offspring emerged and the significance of cooperation for family economy and daily life between parents and offspring rose in importance.Also,the prevalence of immediate families with three generations climbed while the standard nuclear families declined,the ratio of middle-aged couples with young children that worked outside the home increased,the function of middle-aged and senior parents in the upbringing of infants and children enhanced,and the commonness of incomplete family types such as only grandparents with grandchildren increased.During this phase,the number of seniors living alone surged to the point of becoming a matter worthy of attention.
基金National Social Science Fund Project 2016(16BKS047)
文摘Under the pressure of marketization and urbanization,rural family reproduction mode has transformed from simple reproduction to expanded family reproduction,thus changing the family structure and family relationship.Under the mode of expanded family reproduction,family relationship is a highly rational and deeply mobilized interaction pattern.And the family element configuration profoundly reflects the practical form of family relationship.Under the mode of expanded family reproduction,the changes in rural family relations are mainly reflected in three aspects:the decline of the paternal authority and the increasing family status of the offspring;the increasing status of women along with a decisive role in family decision-making;the more independent,equal,competitive and rational relationship among brothers.These changes bring forward new requirements on rural governance system,which requires improvements on social security and public culture.
基金Supported by Soft Science Project of Anhui Province ( 10030503038)Research Project of Chuzhou University ( 2010sk0138)the First Federation of social Sciences research Project in Chuzhou City ( B2011020)
文摘At first,this article gives an overview of previous researches on family migration,the pulling force and drag force of the rural residents' behavior of going out. On the basis of questionnaire survey of rural woman's behavior of going out in Anhui Province,conducted in early 2011,this article studies the pulling force and drag force of rural woman's behavior of going out,their will to settle in the city,and the obstacles to settlement. Finally,I derive three pulling forces of rural woman's behavior of going out,and three major factors influencing settlement in city.
文摘Taking 20 relative poor families in Hechuan District of Chongqing Municipality as survey samples,taking 275 households of rural families selected by stratified sampling method as research objects,and taking family education investment behavior of this rural area as research content,this paper studied current situations of rural family education investment behavior in Hechuan District,difference in investment behavior and related influence factors. It is intended to provide references for family education investment of rural areas in Hechuan District and even Chongqing Municipality,and promote development of rural education undertaking in China.
文摘Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additional disparities regarding health care access, job availability, and daily living resources. Hence, the family impact of having a child with asthma may be influenced by geographic locale. This impact could be a result of health insurance tied to employment, out of pocket costs, and health care provider availability. Few studies have assessed the impact a child’s asthma has on a family. This study sought to answer the question: What is the impact of children with asthma on US rural families? Methods: Multivariate techniques were performed to examine a single year of data from two connected population-based datasets, the 2007-2008 National Survey of Children’s Health and the 2009-2010 Children with Special Health Care Needs Survey. Children with current asthma defined the study population for both datasets. A logistic regression model was performed for each database. The dependent variable for the first model was child in family currently has asthma, for the second it was rural children with current asthma. Results: The first logistic regression model confirmed that rural children were more likely to have asthma than non-rural children. The second logistic regression model yielded that rural families with a child diagnosed with asthma had greater odds of: not having health insurance, having a parent who stopped working, avoided a job change, or experienced financial problems because of the child’s health. Conclusions: This study demonstrated that rural families experience a disproportionate financial hardship as a result of their child’s asthma. Pharmacist intervention in asthma care in rural areas has the potential to decrease the financial burden for a family while also improving a child’s health.
文摘To promote coordinated population and socioeconomic development in rural areas and alleviate special difficulties confronting rural households that practice family planning, and have only one child or two female children, we have formulated this plan in line with the Opinions of the National Population and Family Planning Commission and the Ministry of Finance on Piloting Work for Rewarding and Assisting Selected Rural Households That Practice Family Planning, as forwarded by the State Council General Office.
文摘In order to solve the practical difficulties of rural households practicing family planning, further implement the population and family planning program and promote the establishment of coordinated and harmonious communities in rural areas,the central government launched a pilot project to reward and support rural families practicing family planning in five western provinces and ten cities in 2004. In 2005, the pilot sites were expanded to 23 more provinces and parts of Shandong and Tibet.
文摘Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.
文摘With the implementation of the policy of popularization of education, rural families make the choice of interests and behavior decisions through the calculation of their own benefits and costs, and gradually become the main body of rural education investment decisions. The relationship between educational cost and income plays a major role in the rural family education investment. Based on the current situation of rural education in our country, this paper focuses on the risk of rural education investment and rural education costs and benefits, and then puts forward scientific, operational measures and suggestions.
文摘However, with the development of economy and the aging of the population, this kind of old-age model is facing many problems, and the family pension function is weakened gradually. Therefore, based on this, the old-age pension system is still in the family. The situation of China's rural old-age security research has important practical significance.
文摘In order to provide a policy basis for improving the early development of poor rural children,this paper uses quantitative data and quantitative research methods to study the early development of children in poor rural areas and the impact of family environmental quality on such development. The results show that the early development of poor rural children,especially the ability of social emotion is not perfect,and the quality of family environment has a significant impact on the early development of poor rural children. Therefore,in order to improve the early development of rural children,it is necessary to attach importance to the improvement of family environment and increase the interaction with children. The government needs to establish and improve the mechanism of providing early development services,increase investment and find more efficient service model.
文摘With our country’s social development,the gap between urban and rural education has become increasingly obvious,especially the difference in student achievement.This study aims to explore the impact of the urban-rural education gap on student achievement.The study adopts a quantitative analysis method to collect and analyze the academic performance,learning resources,and social resources of urban and rural students.The results show that the unbalanced distribution of educational resources in urban and rural areas is the key factor leading to the gap in students’achievement.For example,urban education resources are abundant while rural education resources are relatively scarce.At the same time,the difference in social environment and family economic status also have a significant impact on student achievement.The differences between urban and rural areas,particularly in terms of family economic conditions and their ability to invest in education,further widen the gap between urban and rural education.The results of this study can provide a reference for reducing the gap between urban and rural education and improving the academic performance of rural students.A fair education policy is essential to narrow the gap between urban and rural education resources distribution,so as to improve the equality of education in society.
文摘背景高血压是心血管疾病主要的危险因素,降压用药不仅要考虑患者血压特征,也要考虑患者合并症情况。现阶段,基于家庭医生签约服务对高血压患者的服药状况及影响因素研究比较缺乏。目的调查安徽省界首市家庭医生签约服务的高血压患者服药现状,描述患者服药行为与患者特征之间的关联,探索患者用药调整的影响因素,并分析基层高血压患者用药的合理性。方法采用整群抽样的方法,于2021年7—8月从安徽省界首市随机抽取48个行政村,通过面对面调查法采用自制问卷收集患者特征和服药数据,参照《国家基层高血压防治管理指南2020版》将问卷中患者提到的降压药分为如下5类:A类为血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB),B类为β受体阻滞剂,C类为钙通道阻滞剂(CCB),D类为利尿剂,E类为单片复方制剂。通过科大讯飞智能语音血压计的后台获取患者上传的近1年血压数据,分析不同特征患者的服药行为。采用多因素Logistic回归分析探讨高血压患者用药调整的影响因素。本研究中联合用药是指服用复方制剂或2种以上降压药,用药调整是指患者过去服用其他降压药。结果本研究共纳入高血压患者3005例,其中男1291例(43.0%)、女1714例(57.0%),平均年龄为(65.5±9.8)岁,高血压服药率为79.1%,联合用药率为40.2%。2376例服用降压药的患者中,不同类型降压药服用率从高到低依次为(部分患者存在联合用药):E类(39.6%)、C类(35.1%)、D类(20.3%)、A类(20.1%)、B类(3.7%);服用最多的降压药为复方利血平(33.7%)。对于年均血压≥160/100mm Hg的患者,仍有12.2%和4.9%未服用降压药。患者联合用药以E类降压药为主。年均“舒张压≥100 mm Hg”且“患合并症”的患者,调整后A类和C类降压药的服用率增加相对较多,年均“收缩压≥160 mm Hg”且“未患合并症”的患者,调整后E类降压药的服用率增加相对较多。多因素Logistic回归结果显示,服药年数长(OR=1.042,95%CI=1.031~1.053,P<0.001)、初中以上文化程度(OR=1.488,95%CI=1.195~1.853,P<0.001)、合并高脂血症(OR=1.267,95%CI=1.052~1.525,P=0.013)、合并心血管疾病(OR=1.394,95%CI=1.166~1.667,P<0.001)、合并脑血管疾病(OR=1.258,95%CI=1.040~1.522,P=0.018)是患者用药调整的促进因素,高龄(OR=0.980,95%CI=0.971~0.990,P<0.001)是用药调整的抑制因素。结论界首市农村地区高血压患者的服药率较高,主要服用E类和C类降压药。服药年数长、初中以上文化程度、合并高脂血症、合并心脑血管疾病是患者用药调整的促进因素,高龄是用药调整的抑制因素。
文摘背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有效性提供参考依据。方法于2023年1—4月,遵循范围综述报告规范清单,于Web of Science、PubMed、Embase、Medline、CINAHL、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库检索有关家庭医生签约服务老年人健康管理的文献,检索时限为建库至2022-12-31。根据纳入和排除标准,基于社会生态学模型审查、总结和分析影响农村家庭医生签约服务老年人健康管理实践的因素。结果共纳入27篇文献,提取了与农村家庭医生签约服务老年人健康管理相关的个人、人际、组织、社区及政策5个层面的影响因素。结论农村家庭医生签约服务老年人健康管理实践受到多层面、多因素影响,推动农村地区签约服务老年人健康管理发展需综合考虑其影响因素,明确各责任部门、主体的权利和义务,合力促进以家庭医生签约服务为载体的健康管理服务提质增效。