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Zhang X, Huang J, Luo Y. The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China's urban and rural residents' medical insurance. BMC Public Health 2021; 21:1444. [PMID: 34294053 DOI: 10.1186/s12889-021-11367-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background With the rapid growth of the ageing population, the operating burden of China’s basic medical insurance fund is becoming increasingly heavy. To counter rapid population ageing and ameliorate a series of problems, China has adjusted its fertility policies several times. On January 1, 2016, the universal two-child policy was implemented. This study analysed the impacts of the adjustment to the fertility policy and potential improvements in fertility intention on the insured population and medical insurance fund sustainability. Methods We used an actuarial science method and took the urban and rural residents’ basic medical insurance (URRBMI) of China, which covers most urban and rural residents, as an example to build a dynamic forecast model of population growth and a dynamic actuarial model of medical insurance funds. Results Compared with the original policy, under the current fertility intention (40%) with the universal two-child policy, the ageing of the population structure of URRBMI participants will decline significantly after 2026, and individuals aged 65 and over will account for only 19.01% of the total participants in 2050. The occurrence of the current deficit and accumulated deficit of the URRBMI fund will be postponed for one year to 2022 and 2028, respectively. If fertility intentions continue to rise, the ageing degree of the population structure will decrease, and the deficit would be further delayed. Conclusions The universal two-child policy is conducive to improving the degree of overall population ageing, delaying the occurrence of a URRBMI fund deficit, and improving the sustainability of URRBMI funds. If fertility intention increases, the effects would be stronger. However, since the adjustment of the universal two-child policy has a certain time lag, it will take time to demonstrate this impact. Therefore, while actively promoting the universal two-child policy, other measures should be taken, such as improving the fertility desire among couples of childbearing age and reforming medical insurance payment methods.
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Nam JS, Hwang CS, Hong MP, Kim KS. Prevalence and clinical characteristics of allergic rhinitis in the elderly Korean population. Eur Arch Otorhinolaryngol 2020; 277:3367-73. [PMID: 32743711 DOI: 10.1007/s00405-020-06256-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/27/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE The proportion of elderly people aged ≥ 65 years is increasing worldwide. Although the reported prevalence of sinonasal disease can vary according to the diagnostic methods used, differences in allergic rhinitis prevalence in the elderly according to diagnostic method have not been reported. We thus aimed to evaluate allergic rhinitis prevalence in the elderly according to diagnostic criteria obtained from questionnaires, physician diagnoses, and allergy tests. METHODS We compared the allergic rhinitis prevalence in the elderly aged ≥ 65 years with adults aged 19-64 years, using data from the Korean National Health and Nutrition Examination Survey 2008-2012. Total serum IgE and IgE levels specific to allergens of Dermatophagoides farina, cockroach, and dog dander were examined, and factors affecting specific IgE levels were investigated. RESULTS Allergic rhinitis prevalence according to the questionnaire responses, physician diagnoses, and allergy test results was 35.02%, 14.89%, and 17.56%, respectively. The prevalence based on all diagnostic methods assessed was significantly lower in the elderly than in the general adult group (p < 0.001). Rhinorrhea incidence was significantly increased in the elderly (p = 0.018). Sensitization to Dermatophagoides farina was significantly decreased in the elderly (p = 0.006) and did not correlate with socioeconomic status and/or general health factors. CONCLUSIONS The elderly population has a distinct clinical presentation, including a low prevalence of allergic rhinitis, and an increased incidence of rhinorrhea symptoms, compared with the general adult population. The management of allergic rhinitis in elderly patients may therefore require a different therapeutic approach to improve rhinorrhea rather than nasal obstruction.
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Kämpfen F, Kohler IV, Bountogo M, Mwera J, Kohler HP, Maurer J. Using grip strength to compute physical health-adjusted old age dependency ratios. SSM Popul Health 2020; 11:100579. [PMID: 32490133 PMCID: PMC7262450 DOI: 10.1016/j.ssmph.2020.100579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/21/2022] Open
Abstract
The standard approach for comparing the potential challenges of population aging across countries based on conventional old-age dependency ratios (OADR) does not account for cross-population differences in health, functional capacity or disability, despite their importance for labor force participation and dependency more broadly. We investigate how OADRs observed across selected low-, middle-, and high-income countries change if population differences in physical health measured by hand-grip strength are accounted for. Specifically, we propose and calculate an adjusted measure of the OADR based on hand-grip strength, which serves as an objective indicator of muscle function and has been shown to predict future morbidity, disability and mortality. We show that adjusting the OADR for differences in hand-grip strength results in substantial changes in country rankings by OADR compared to a ranking based on the conventional OADR definition. Accounting for cross-population differences in hand-grip strength, the estimated OADRs for low- and middle-income countries tend to increase compared to the conventional OADR approach based on age only, whereas the estimated OADRs in high-income countries decline substantially relative to the standard approach. Since hand-grip strength is an important prerequisite for maintaining functional capacity and productivity and preventing disability -especially in economies in low-income settings- our grip-strength-adjusted OADRs clearly show that population aging is not just a challenge in high-income countries but also an important concern for economies in the developing world.
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Affiliation(s)
- Fabrice Kämpfen
- Department of Economics, HEC, University of Lausanne, Switzerland
- Population Studies Center, University of Pennsylvania, PA, United States
| | - Iliana V. Kohler
- Population Studies Center, University of Pennsylvania, PA, United States
| | - Mamadou Bountogo
- Centre de Recherche en Santé de Nouna, Nouna, Boucle du Mouhoun, Burkina Faso
| | - James Mwera
- Invest in Knowledge Initiative (IKI), Zomba, Malawi
| | - Hans-Peter Kohler
- Population Studies Center, University of Pennsylvania, PA, United States
| | - Jürgen Maurer
- Department of Economics, HEC, University of Lausanne, Switzerland
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Li C, Sun J, Zhao H, Dai T. Association between Frailty and Erectile Dysfunction among Chinese Elderly Men. Biomed Res Int 2020; 2020:9247237. [PMID: 32724818 DOI: 10.1155/2020/9247237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/30/2020] [Indexed: 12/29/2022]
Abstract
Objective This study is aimed at assessing association between frailty and erectile dysfunction among Chinese elderly men. Methods This community-based study was conducted with a sample of 341 Chinese elderly men (aged 60 to 83 years old) in Fuyang City (Anhui Province, China). Each of the participants completed a standard questionnaire, including demographics (age, height, weight, yearly income, educational status, comorbidity, lifestyle factors, etc.), medical and sexual history, and the Chinese version of Tilburg Frailty Indicator (TFI) and International Index of Erectile Function-5 (IIEF-5) for assessing frailty and erectile dysfunction (ED). Results The prevalence of ED and frailty in Chinese elderly men was 77.13% and 68.04%, respectively. Compared with the non-ED group, the ED group had increased age, spouse's age, BMI, prevalence of diabetes, and scores of TFI and lower yearly income, educational levels, and ratio of irregular intercourse (less than once per week) (all P < 0.05). Multivariate analysis indicated that age (OR: 0.860, 95% CI: 0.763-0.969), diabetes (OR: 0.330, 95% CI: 0.165-0.661), irregular intercourse (OR: 3.416, 95% CI: 1.874-6.229), and scores of TFI (OR: 0.906, 95% CI: 0.846-0.970) were regarded as independent risk factors for ED (all P < 0.05). And after adjusting for age, the TFI score had a negative significant association with the IIEF score (r = −0.134, P = 0.013). Conclusion This study confirmed the strong associations between ED and frailty among elderly men. Sexual health care for elderly men with ED should be assessed and taken addressed on the multidimensional assessments of frailty.
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Azarpazhooh MR, Mandzia JL, Thrift AG, Sposato LA, Morovatdar N, Amiri A, Kapral MK, Yassi N, Bahit C, Kaul S, Alladi S, Nilanont Y, Coppola M, Nucera A, Silver B, Werring D, Simister R, Swartz RH, Owolabi MO, Ovbiagele B, Hachinski V. Age, sex, and setting in the etiology of stroke study (ASSESS): Study design and protocol. J Neurol Sci 2019; 399:209-213. [PMID: 30851659 DOI: 10.1016/j.jns.2019.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/21/2019] [Accepted: 02/13/2019] [Indexed: 12/01/2022]
Abstract
RATIONALE Stroke etiology and risk factors vary by age, sex, setting (hospital or community-based) and by region. Identifying these differences would improve our understanding of stroke etiology, diagnosis, and treatment. AIM The Age, Sex and Setting in the Etiology of Stroke Study (ASSESS) is a multicenter cohort study to assess differences in stroke etiology. METHODS AND DESIGN Data from all centers will be categorized according to age, sex, setting, stroke subtypes. Centers with extensive hospital- or community-based data regarding stroke from Argentina, Australia, Canada, India, Iran, Italy, Ghana, Nigeria, Thailand, the United Kingdom and the United States have agreed to participate so far. STUDY OUTCOMES The primary outcome includes differences in stroke etiology in study centers. The secondary outcomes include stroke incidence, risk factors, preventive strategies, and short- and long-term outcomes. CONCLUSION ASSESS will enable comparisons of data from different regions to determine the age and sex distribution of the most common causes of stroke in each setting. This will help clinicians to tailor the assessment and treatment of stroke patients on the basis of their specific local characteristics. It will also empower stroke epidemiologists to design preventive measures by targeting the specific characteristics of each population.
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Affiliation(s)
- Mahmoud Reza Azarpazhooh
- Department of Neurology, Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada; Department of Epidemiology and Biostatistics, Western University, ON, Canada
| | - Jennifer L Mandzia
- Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada
| | - Amanda G Thrift
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Luciano A Sposato
- Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada; Department of Epidemiology and Biostatistics, Western University, ON, Canada; Department of Anatomy and Cell Biology, Western University, ON, Canada; Stroke, Dementia, and Heart Disease Lab, Western University, ON, Canada
| | - Negar Morovatdar
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Amiri
- Department of Neurology, Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moira K Kapral
- Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Nawaf Yassi
- Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Cecilia Bahit
- Cardiology Department, INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina
| | - Subhash Kaul
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Yongchai Nilanont
- Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Antonia Nucera
- Department of Neurology, Saint Andrea Hospital, Stroke Unit, La Spezia, Italy
| | - Brian Silver
- Department of Neurology, The University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, MA, United States
| | - David Werring
- Stroke Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Robert Simister
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Richard H Swartz
- Department of Medicine, Division of Neurology, Sunnybrook HSC, University of Toronto, Toronto, Canada
| | - Mayowa O Owolabi
- Center for Genomic and Precision Medicine, University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- Department of Neurology, University of California, San Francisco, USA
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada; Department of Epidemiology and Biostatistics, Western University, ON, Canada.
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Lee HS, Ko M, Park SW, Braden H. Concurrent validity of the Groningen Meander Walking and Timed Up and Go tests in older adults with dementia. Physiother Theory Pract 2019; 36:1432-1437. [PMID: 30739570 DOI: 10.1080/09593985.2019.1579285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background and Purpose: The Groningen Meander Walking time (GMW-sec) test has not been clinically validated as a feasible assessment to test functional mobility skills. The purpose of this study was to determine the concurrent validity of the GMW-sec test with the Timed Up and Go (TUG) test in older adults with dementia. Methods: This study included a cross-sectional and between subjects design with one factor, which had three different levels of group. Consecutive sampling was used to recruit 145 elderly participants in dementia and senior care facilities. Participants were divided into three groups based on the result of a Mini-Mental Status Exam for Dementia Screening: 57 older adults with dementia, 25 older adults with mild cognitive impairment, and 63 healthy older adults. Results: Spearman rank order correlation showed that the TUG test had moderate association with the GMW-sec test not only in older adults with dementia (r = 0.69; p < 0.01), but also for the mild cognitive group (r = 0.63; p = 0.01) and healthy group (r = 0.47; p < 0.01). Older adults with dementia had a significant functional reduction for both GMW-sec and TUG tests compared to other two groups (p < 0.01). Discussion and Conclusion: Turning motions with the TUG test may cause similar challenges that relate to a curved walking path for the GMW-sec test in older adults with dementia. Both the TUG and GMW-sec tests could be effective approaches for screening the severity of cognitive impairment on functional mobility in people with dementia.
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Affiliation(s)
- Han-Suk Lee
- Department of Physical Therapy, Eulji University , Seongnam-si, Gyeonggi-do, South Korea
| | - Mansoo Ko
- Department of Physical Therapy, University of Texas Medical Branch , Galveston, Texas, USA
| | - Sun-Wook Park
- Department of Physical Therapy, Samsung Medical Center , Gangnam-gu, Seoul, South Korea
| | - Heather Braden
- Department of Physical Therapy, Angelo State University , San Angelo, Texas, USA
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Van Oyen H, Bogaert P, Yokota RTC, Berger N. Measuring disability: a systematic review of the validity and reliability of the Global Activity Limitations Indicator (GALI). ACTA ACUST UNITED AC 2018; 76:25. [PMID: 29881544 PMCID: PMC5985596 DOI: 10.1186/s13690-018-0270-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/09/2018] [Indexed: 12/03/2022]
Abstract
Background GALI or Global Activity Limitation Indicator is a global survey instrument measuring participation restriction. GALI is the measure underlying the European indicator Healthy Life Years (HLY). Gali has a substantial policy use within the EU and its Member States. The objective of current paper is to bring together what is known from published manuscripts on the validity and the reliability of GALI. Methods Following the PRISMA guidelines, two search strategies (PUBMED, Google Scholar) were combined to identify manuscripts published in English with publication date 2000 or beyond. Articles were classified as reliability studies, concurrent or predictive validity studies, in national or international populations. Results Four cross-sectional studies (of which 2 international) studied how GALI relates to other health measures (concurrent validity). A dose-response effect by GALI severity level on the association with the other health status measures was observed in the national studies. The 2 international studies (SHARE, EHIS) concluded that the odds of reporting participation restriction was higher in subjects with self-reported or observed functional limitations. In SHARE, the size of the Odds Ratio’s (ORs) in the different countries was homogeneous, while in EHIS the size of the ORs varied more strongly. For the predictive validity, subjects were followed over time (4 studies of which one international). GALI proved, both in national and international data, to be a consistent predictor of future health outcomes both in terms of mortality and health care expenditure. As predictors of mortality, the two distinct health concepts, self-rated health and GALI, acted independently and complementary of each other. The one reliability study identified reported a sufficient reliability of GALI. Conclusion GALI as inclusive one question instrument fits all conceptual characteristics specified for a global measure on participation restriction. In none of the studies, included in the review, there was evidence of a failing validity. The review shows that GALI has a good and sufficient concurrent and predictive validity, and reliability.
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Affiliation(s)
- Herman Van Oyen
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium.,2Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
| | - Petronille Bogaert
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Renata T C Yokota
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium.,3Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Nicolas Berger
- 4Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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Asker A, Assal SFM, Ding M, Takamatsu J, Ogasawara T, Mohamed AM. Modeling of natural sit-to-stand movement based on minimum jerk criterion for natural-like assistance and rehabilitation. Adv Robot 2017. [DOI: 10.1080/01691864.2017.1372214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ahmed Asker
- Mechatronics and Robotics Engineering Department, School of Innovative Design Engineering, Egypt-Japan University of Science and Technology, Alexandria, Egypt
| | - Samy F. M. Assal
- Mechatronics and Robotics Engineering Department, School of Innovative Design Engineering, Egypt-Japan University of Science and Technology, Alexandria, Egypt
- Faculty of Engineering, Department of Production Engineering and Mechanical Design, Tanta University, Tanta, Egypt
| | - Ming Ding
- School of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Jun Takamatsu
- School of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Tsukasa Ogasawara
- School of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - A. M. Mohamed
- Mechatronics and Robotics Engineering Department, School of Innovative Design Engineering, Egypt-Japan University of Science and Technology, Alexandria, Egypt
- Faculty of Engineering, Electrical Engineering Department, Assiut University, Assiut, Egypt
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Collins S, Stevenson D, Bennett A, Walker J. Occurrence of Legionella in UK household showers. Int J Hyg Environ Health 2017; 220:401-406. [DOI: 10.1016/j.ijheh.2016.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
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