Abstract

Background: Health-related behaviours (HRBs) cluster within individuals. Evidence for the association between HRB clustering and cognitive functioning is limited. We aimed to examine and compare the associations between three HRB clusters: “multi-HRB cluster”, “inactive cluster” and “(ex-)smoking cluster” (identified in previous work based on HRBs including smoking, alcohol consumption, physical activity and social activity) and episodic memory trajectories among men and women, separately, in the United States of America (USA) and England.

Abstract

Objectives: Previous investigations of cognitive aging have mainly focused on structural aspects of social relations (e.g. network size and composition), thereby neglecting the role of qualitative aspects of social relations. The current longitudinal study examined sex-specific differences in verbal memory decline by measures of perceived relationship quality (social support/strain) by relationship type. Method: In the English Longitudinal Study of Ageing (ELSA), 10,109 participants aged 50-89 years were assessed at wave 1 (baseline: 2002-03) and followed to wave 9 (2017-18). Verbal memory was assessed by immediate and delayed word-recall tasks. Social support/strain was measured by relationship type (spouse; children; family; friends). Random effects within-between (REWB) modelling was used to separate between- and within-person effects. We estimated associations between social support/strain and (1) baseline levels of memory (main effects), and (2) rate of decline in memory (interaction with time-since-baseline). Results: Longitudinal associations were most prominent for men, specific to relationship type, and showed between- rather than within-person effects. Among men, higher spousal strain was associated with faster memory decline (βbetween-effect×time = -0.043; 95% CI [-0.084, -0.002]; p = .039), whilst greater support from children was associated with slower decline (βbetween-effect×time = 0.020; 95% CI [0.002, 0.039]; p = .033). Men with higher strain from friends showed lower baseline memory (βbetween-effect = -0.382; 95% CI [-0.627, -0.137]; p=.002) and faster decline (βbetween-effect×time = -0.047; 95% CI [-0.095, 0.000]; p = .051). Conclusion: Between-person differences in social support/strain were modestly associated with memory decline, especially among men.

Abstract

Objective: To develop and validate an index to quantify the multimorbidity burden in Chinese middle-aged and older community-dwelling individuals.

Methods: We included 20,035 individuals aged 45 and older from the China Health and Retirement Longitudinal Study (CHARLS) and 19,297 individuals aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Health outcomes of physical functioning (PF), basic and instrumental activities of daily living (ADL and IADL) and mortality were obtained. Based on self-reported disease status, we calculated five commonly used western multimorbidity indexes for CHARLS baseline participants. The one that predicted the health outcomes the best was selected and then modified through a linear mixed model using the repeated individual data in CHARLS. The performance of the modified index was internally and externally evaluated with CHARLS and CLHLS data.

Abstract

Background: Studies have shown the existence of health concordance between patients with type 2 diabetes mellitus (T2DM) and their spouses, and also that spouses could influence the effect of self-management, benefiting patients’ health. However, these studies are heterogeneous and the evidence is inconclusive.

Abstract

目的探讨基于同伴支持的翻转课堂模式应用于全球卫生课程中的效果及其影响因素。方法选取中山大学2016级预防医学专业与2018级护理学专业共141名学生作为教学对象,实施基于同伴支持的翻转课堂教学模式,采用多元化考核模式进行学生考核。通过2次随堂测试成绩的比较和教学满意度问卷评价教学效果,并以前后测试成绩差值作为学生学习效果指标,分析多元化考核模式与学生学习效果的关系。结果第2次随堂测试平均成绩(63.16±22.17)分较第1次(50.77±12.62)分提升12.39分(P<0.01),课程整体满意度得分为(74.19±19.54)分。多因素回归分析发现,多元化考核模式对前后测试成绩提高并无统计学意义。结论基于同伴支持的翻转课堂模式在全球卫生教学中可行有效,学生对翻转课堂的实施态度积极,多元化考核模式如何影响学生学习效果仍需进一步研究。

Abstract

Backgrounds: This study examined the dynamic association between risk communication and the public’s risk perception and action across the COVID-19 outbreak timeline in China.

Methods: This study collected publicly available information on COVID-19 released on official channels (e.g., government websites and official media) by the Parehub tool. Also, the study used the Zhongyun Big Data Platform to search public datasets about released COVID-19 information on Chinese social media, such as TikTok and Weibo. An online survey was conducted via WeChat to Chinese citizens using a snowball sampling method. The questionnaire assessed changes in participants’ risk perception and action against COVID-19. The data analysis examined information content and release-time trajectories against the public’s risk perception and actions over time.

Abstract

Objective: To describe the characteristics of oldest-old Chinese with disability and their adult-child caregivers, and the extent to which these characteristics were associated with caregiver burden.

Methods: The study was based on 168 pairs of disabled oldest-old adults and their adult-child caregivers, derived from the Chinese Longitudinal Healthy Longevity Survey. Descriptive analyses of care recipients’ and caregivers’ characteristics were conducted respectively, in reference to caregiver burden. Statistically significant characteristics identified in these bivariate analyses were then jointly evaluated in multiple linear regression models with caregiver burden as the outcome.

Abstract

Background: Family-centered care, as a contemporary model of health service delivery, involves a mutually beneficial partnership between healthcare providers, patients and their families. Although evidence on the positive effects of family-centered care on older adults and their families is accumulating, less is known about the providers’ beliefs, attitudes and practices related to family-centeredness, especially regarding community-based primary healthcare services for the rapidly-ageing Chinese population.

Abstract

This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Data of 3420 couples were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e., age, education, retirement status and household income), and their individual lifestyle (i.e., smoking, drinking, exercise, social participation and BMI) all measured at baseline. The incidence of chronic diseases after 4 years of follow-up was 22.95% in the husbands (605/2636) and 24.71% in the wives (623/2521). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had chronic diseases at baseline showed an increased risk of developing chronic diseases over 4 years (ORadjusted = 1.24, 95%CI: 1.02, 1.51), but this risk was not statistically-significant for wives (ORadjusted = 0.88, 95%CI: 0.71, 1.08). Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.