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Impact of the Economic Crisis on Endocarditis Mortality in Spain: A Nationwide Study. 经济危机对西班牙心内膜炎死亡率的影响:一项全国性研究。
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-07-01 Epub Date: 2021-04-29 DOI: 10.1177/00207314211012357
Christian Ortega-Loubon, Gema Ruiz López Del Prado, María F Muñoz-Moreno, Esther Gómez-Sánchez, Rocío López-Herrero, Belén Sánchez-Quirós, Mario Lorenzo-Lopez, Estefanía Gómez-Pesquera, Pablo Jorge-Monjas, Juan Bustamante-Munguira, F Javier Álvarez, Salvador Resino, Eduardo Tamayo, María Heredia-Rodríguez

Economic recession has dire consequences on overall health. None have explored the impact of economic crisis (EC) on infective endocarditis (IE) mortality. We conducted a retrospective, nationwide, temporal trend study analyzing mortality trends by age, sex, and adverse outcomes in patients diagnosed with IE in Spain from 1997 to 2014. Data were divided into two subperiods: pre-EC (January 1997-August 2008) and post-EC (September 2008-December 2014). A total of 25 952 patients presented with IE. The incidence increased from 301.4 to 365.1 per 10 000 000 habitants, and the mortality rate rose from 24.3% to 28.4%. Those aged >75 years experienced more adverse outcomes. Complications due to sepsis, shock, acute kidney injury requiring dialysis, and heart failure increased after the EC onset, and expenditures soared to €16 216. Expenditure per community was related to mortality (P < .001). The EC resulted as an independent predictor for mortality (hazard ratio 1.06; 95% confidence interval 1.01-1.11). Incidence and mortality rate in patients with IE after the onset of the EC have increased as a result of rising adverse outcomes despite an overall increased investment.

经济衰退会对整体健康造成可怕的后果。没有研究探讨经济危机(EC)对感染性心内膜炎(IE)死亡率的影响。我们进行了一项回顾性的、全国性的、时间趋势研究,分析了1997年至2014年西班牙诊断为IE的患者按年龄、性别和不良后果划分的死亡率趋势。数据分为两个时期:欧盟前(1997年1月- 2008年8月)和欧盟后(2008年9月- 2014年12月)。共有25952例患者出现IE。发病率从每1000万居民301.4例上升到365.1例,死亡率从24.3%上升到28.4%。年龄>75岁的人有更多的不良后果。败血症、休克、需要透析的急性肾损伤和心力衰竭等并发症在EC发作后增加,支出飙升至16216欧元。每个社区的支出与死亡率有关(P
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引用次数: 1
Recognition Investigation of Community Pharmacists Implementing Good Pharmacy Practice in Korea. 韩国社区药师实施良好药学规范的认知调查。
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-07-01 Epub Date: 2020-07-13 DOI: 10.1177/0020731420941459
Dae-Won Kim, Beom-Jin Lee

This study aimed to verify, for the first time, the need for Good Pharmacy Practice (GPP) regulations as guidelines to provide pharmaceutical care services in community pharmacies in Korea. Statistical analyses were performed with demographic characteristics, institutional factors, and diversity factors of 3 pharmaceutical care services as independent variables and the favorability of GPP implementation as a dependent variable. In assessing the diversity of methods of providing pharmaceutical care services as an indicator of willingness to provide these services, this study understood such diversity as an innovative behavior that represents the efforts and willingness of pharmacists to provide better services. The results of descriptive statistics showed that most pharmacists in community pharmacy recognize that guidelines are necessary to provide better pharmaceutical care services. The statistical correlation analysis results confirmed that a greater need for guidelines was strongly related to higher GPP favorability. The institutional factors had the greatest influence on GPP favorability, rather than diversity factors of pharmaceutical care services, ultimately with the Korean perspectives to equate the GPP with the guidelines for pharmaceutical care services. Our study confirmed that it is a wish and a policy task of community pharmacists in Korea to enact GPP as soon as possible.

本研究旨在验证,第一次,需要良好的药房规范(GPP)法规作为指导方针,在韩国的社区药房提供药学服务。以3个药学服务机构的人口学特征、制度因素和多样性因素为自变量,实施GPP的有利程度为因变量进行统计分析。在评估提供药学服务方法的多样性作为提供这些服务意愿的指标时,本研究将这种多样性理解为一种创新行为,它代表了药剂师提供更好服务的努力和意愿。描述性统计结果显示,大多数社区药房的药剂师认识到指南是提供更好的药学服务的必要条件。统计相关分析结果证实,对指南的更大需求与更高的GPP好感度密切相关。制度因素对GPP好感度的影响最大,而非药学服务的多样性因素,最终韩国视角将GPP等同于药学服务指南。我们的研究证实,尽快制定GPP是韩国社区药师的愿望和政策任务。
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引用次数: 2
A New Journal for a New Era 面向新时代的新刊
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-06-15 DOI: 10.1177/00207314221102882
J. Benach, C. Muntaner
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引用次数: 2
Past, Present, and Future of the International Journal of Health Services 《国际卫生服务杂志》的过去、现在和未来
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-06-15 DOI: 10.1177/00207314221104544
Vicente Navarro
The International Journal of Health Services was established more than half a century ago to provide a forum for the analysis of those services that have as an explicit function the prevention of disease and promotion of health, understanding health (as the World Health Organization’s Constitution does) “as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” This understanding of health includes quality of life and the biological, psychological, and social well-being of the individual and of the population: health is both an individual and a collective phenomenon. Several people who were instrumental in the development of that WHO definition of health, such as Karl Evang (co-founder of the WHO and previously Director of the Norwegian Directorate for Health) and John Brotherston (who had been Professor of Public Health and Social Medicine in Edinburgh and, later, Chief Medical Officer of Scotland), encouraged the establishment of this journal. I had been a student of Brotherston in the early 1960 s at the Usher Institute in Edinburgh and had the pleasure to know Evang when he visited what was then called the John Hopkins School of Hygiene and Public Health. I consulted with them, and they were both very supportive of the Journal’s creation. The key person in the establishment of the Journal, however, was Professor Kerr L. White, a Canadian who had played an important role in the founding of the National Health Program in Canada. Hopkins invited him to establish the Department of Medical Care and Hospitals, and Kerr invited me to join the department when I finished my studies in Scotland. One of his first requests of me when I joined the faculty was to start the Journal, a proposal I had made previously. Many others added their voices to support the need for the Journal. From the beginning, the Journal had the vocation of learning about reality in order to change it—that is, to improve it. The period in which the journal was founded, the early 1970 s, was a moment of great creativity and inquiry in academic institutions in many parts of the world. It had followed the 1960 s, known for their questioning of the excessive conservative values and policies carried out in the 1950 s. It was in this context that scholars from many parts of the world agreed on establishing the Journal with the title International Journal of Health Services. The word “International” signaled the desire to have a broad plurality of positions between, among, and within countries, providing a forum for debate on the major issues of the moment. An Editorial Board with approximately 30 well-known and highly respected scholars from many countries, assisted by an equally international body of Editorial Consultants who constituted the axis of an extensive network of reviewers, guaranteed—and continues to guarantee—the excellence and scientific rigor of the articles and contributions to the Journal. Their function was to a
《国际卫生服务杂志》成立于半个多世纪前,旨在为分析那些具有预防疾病和促进健康明确功能的服务提供一个论坛,理解健康(正如世界卫生组织章程所做的那样)“作为一种完全的身体、心理和社会幸福的状态,而不仅仅是没有疾病或虚弱。”这种对健康的理解包括生活质量以及生物、心理、,以及个人和人民的社会福利:健康既是一种个人现象,也是一种集体现象。一些对世界卫生组织健康定义的发展起到了重要作用的人,如Karl Evang(世界卫生组织联合创始人,前挪威卫生局局长)和John Brotherston(曾任爱丁堡公共卫生和社会医学教授,后任苏格兰首席医疗官),鼓励创办这本杂志。20世纪60年代初,我曾是Brotherston在爱丁堡亚瑟学院的学生,当Evang参观当时被称为约翰·霍普金斯卫生与公共卫生学院时,我很高兴认识了他。我咨询了他们,他们都非常支持《华尔街日报》的创办。然而,创办《华尔街日报》的关键人物是Kerr L.White教授,他是一名加拿大人,在加拿大国家卫生计划的创建过程中发挥了重要作用。霍普金斯邀请他建立医疗保健和医院系,克尔邀请我在苏格兰完成学业后加入该系。当我加入学院时,他对我的第一个要求是创办《华尔街日报》,这是我之前提出的一个建议。许多其他人也加入了他们的声音来支持对《华尔街日报》的需求。从一开始,《华尔街日报》就有了解现实的使命,以改变现实,也就是改进现实。《华尔街时报》创办的20世纪70年代初,是世界许多地方学术机构极具创造力和探索性的时刻。它发生在20世纪60年代,以质疑20世纪50年代过度保守的价值观和政策而闻名。正是在这种背景下,来自世界各地的学者同意创办《国际卫生服务杂志》。“国际”一词表示希望在国家之间、国家之间和国家内部拥有广泛的立场,为就当前重大问题进行辩论提供论坛。一个由来自许多国家的大约30名知名和备受尊敬的学者组成的编辑委员会,在一个同样国际化的编辑顾问机构的协助下,他们构成了一个广泛的审稿人网络的轴心,保证并将继续保证《华尔街日报》的文章和贡献的卓越性和科学严谨性。他们的职能是协助主编和副主编领导《华尔街日报》。在这半个世纪里,编辑委员会和编辑顾问发生了变化,但要特别感谢在整个时期自愿服务的少数人。其中包括几年前去世的来自意大利的Giovanni Berlinguer。我们想念他,感谢他的耐力、慷慨和对《华尔街日报》的承诺。《国际卫生服务杂志》一直是独立的,不与任何协会或机构挂钩。然而,需要向国际卫生政策协会表示赞赏,该协会也是在那个时期成立的,是从事卫生政策工作的专业人员和学者中最大的国际协会,他们认为《日刊》非常需要,并帮助推广,特别是在拉丁美洲。《华尔街日报》最初由Baywood出版社所有,后来被美国最大的学术出版商Sage收购。赞助商一直是约翰霍普金斯大学公共卫生学院。作为该杂志的教员,我是该杂志的创始编辑,从一开始就担任主编。《华尔街日报》的领导层包括一批优秀的副主编(最近,纽约城市大学和美国哈佛大学的David Himmelstein,加拿大多伦多大学的Carles Muntaner,以及纽约城市大学的Stephanie Woolhandler)
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引用次数: 1
Are High-Altitude Residents More Susceptible to Covid-19 in India? Findings and Potential Implications for Research and Policy 在印度,高海拔地区的居民更容易感染Covid-19 ?研究结果及对研究和政策的潜在影响
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-06-05 DOI: 10.1177/00207314221104887
Sushmita Chakraborty, Upasak Das, Udayan Rathore, Prasenjit Sarkhel
In this paper, we study the incidence of COVID-19 and the associated fatality with altitude using high frequency, district level data from India. To understand the implications of the nationwide lockdown after the outbreak, we use data for about four months- two from the lockdown period starting from March 25 till May 31, 2020 and about two months after unlocking was initiated (June 1-July 26, 2020). The multivariate regression result indicates slower growth in average rate of infection during the lockdown period in hilly regions, the gains of which attenuated after the unlocking was initiated. Despite these early gains, the rate of fatalities is significantly higher during the lockdown period in comparison to the plains. The findings remain robust to multiple alternative specifications and methods including one that accounts for confounding possibilities via unobservable and provides consistent estimates of bias adjusted treatment effects. The evidence supports the need for provisioning of public health services and infrastructure upgradation, especially maintenance of adequate stock of life support devices, in high altitude regions. It also underscores the necessity for strengthening and revising the existing Hill Areas Development Programme and integrating important aspects of public health as part of this policy.
在这篇论文中,我们使用来自印度的高频地区级数据研究了新冠肺炎的发病率和与海拔高度相关的死亡率。为了了解疫情爆发后全国封锁的影响,我们使用了大约四个月的数据,其中两个月是从2020年3月25日至5月31日的封锁期,另一个月是在解锁后(2020年6月1日至7月26日)。多元回归结果表明,在封锁期间,丘陵地区的平均感染率增长较慢,解锁后感染率的增长减弱。尽管早期取得了这些进展,但与平原相比,封锁期间的死亡率要高得多。这些发现对多种替代规范和方法仍然是稳健的,其中包括一种通过不可观察的方式解释混杂可能性的规范和方法,并提供对偏差调整治疗效果的一致估计。证据支持在高海拔地区提供公共卫生服务和基础设施升级的必要性,特别是维护足够的生命支持设备库存。它还强调有必要加强和修订现有的山区发展方案,并将公共卫生的重要方面纳入这项政策。
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引用次数: 0
Single-payer Health Care: Financial Implications for a Physician 单一付款人医疗保健:对医生的财务影响
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-05-22 DOI: 10.1177/00207314221096364
Daniel C Bryant
When considering proposed reforms of the U.S. health care system, some physicians dismiss the single-payer model (Medicare for All or state-based universal health care proposals) out of concern that their reimbursement and thus their income would be reduced. This study is an effort to quantitate that concern in the case of state-based plans and, in so doing, to suggest a template for evaluating the financial consequences for physicians of single-payer health care reform in general. To put the data into concrete, practical terms, I envision a hypothetical primary care physician's practice and develop its plausible financial components in the present multi-payer system and in five proposed state-based, single-payer systems. The calculations reveal that in all five single-payer plans evaluated, the hypothetical physician's Total Net Income (take-home pay) would exceed that in the current multi-payer system. Whether these results apply to actual practices or not, they suggest that, when considering the financial impact of single-payer reform on their practices, physicians should consider all the financial consequences of such reform, not just the proposed reimbursement level. More quantitative analyses of these important financial variables in different practice settings must be pursued.
当考虑到美国医疗保健系统的改革建议时,一些医生因为担心他们的报销和收入会减少而拒绝单一付款人模式(全民医疗保险或以州为基础的全民医疗保健提案)。本研究旨在量化以州为基础的计划的情况下的担忧,并在此过程中,为评估单一付款人医疗改革对医生的财务后果提供一个模板。为了将数据转化为具体的、实际的术语,我设想了一个假设的初级保健医生的实践,并在目前的多付款人系统和五个拟议的基于州的单一付款人系统中发展其合理的财务组成部分。计算显示,在评估的所有五个单一付款人计划中,假设医生的总净收入(实得工资)将超过目前的多付款人系统。无论这些结果是否适用于实际实践,他们都表明,在考虑单一付款人改革对其实践的财务影响时,医生应该考虑这种改革的所有财务后果,而不仅仅是拟议的报销水平。必须在不同的实践环境中对这些重要的财务变量进行更多的定量分析。
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引用次数: 1
New Bottle, Old Wine? Implications of the World Bank's Systematic Diagnostic Reports for the Rise of Noncommunicable Diseases in the Organization of Eastern Caribbean States 新瓶装旧酒?世界银行系统诊断报告对东加勒比国家组织非传染性疾病上升的影响
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-05-16 DOI: 10.1177/00207314221100322
Kewoba Carter, C. Chaufan
Since its foundation in 1944, the International Bank for Reconstruction and Development, soon renamed the World Bank (hereafter, “the Bank”), has shifted its initial goal of reconstructing post-World War II Europe to promoting economic development and alleviating poverty in Africa, Asia, Latin America, and the Caribbean. Bank assistance is provided through loans awarded to countries that agree to policy changes that the Bank deems necessary to achieve its stated goals. Bank policies—dubbed Structural Adjustment Programs (SAPs) and, over time, superseded by Poverty Reduction Strategy Papers—have been criticized for not only failing to ameliorate underdevelopment and poverty, but for exacerbating both. The most recent Bank approach to development and poverty alleviation, the Systematic Diagnostic Reports (SDR), attempts to address these criticisms. We appraise the SDR for six Organization of Eastern Caribbean States (OECS). All share daunting economic and social challenges, including an ongoing epidemic of noncommunicable diseases (NCDs). We argue that, contrary to the Bank's claims, these challenges will continue under, and may even be exacerbated by, the policies the Report demands, and we elaborate on their implications for NCDs in the OECS and for social and health equity in the region.
自1944年成立以来,国际复兴开发银行(后更名为世界银行)已将其重建二战后欧洲的最初目标转变为促进非洲、亚洲、拉丁美洲和加勒比地区的经济发展和减轻贫困。世行的援助是通过向同意世行认为实现其既定目标所必需的政策改革的国家提供贷款的方式提供的。世行的政策被称为结构调整计划(SAPs),并随着时间的推移被减贫战略文件所取代,这些政策不仅未能改善不发达和贫困状况,而且加剧了这两种状况。世行最新的发展和扶贫方法,即系统诊断报告(SDR),试图解决这些批评。我们评价东加勒比国家组织六个成员国的特别提款权。所有国家都面临严峻的经济和社会挑战,包括非传染性疾病的持续流行。我们认为,与世行的说法相反,这些挑战将在报告要求的政策下继续存在,甚至可能因政策而加剧。我们详细阐述了这些挑战对东加勒比国家组织的非传染性疾病以及该地区的社会和卫生公平的影响。
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引用次数: 0
After More Than 50 Years, Pharmacare (and Dental Care) are Coming to Canada 50多年后,Pharmacare(和牙科护理)来到加拿大
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-05-09 DOI: 10.1177/00207314221100654
J. Lexchin
In March 2022, the New Democratic Party (NDP), Canada's social democratic party, and the centrist Liberal government signed a supply and confidence agreement. In return for the NDP agreeing to vote with the government on all crucial issues until June 2025, the Liberals pledged to bring in both pharmacare and dental care programs. Pharmacare, universal public insurance coverage for prescription drugs, had been promised for more than 50 years but never implemented, while public dental care was an almost completely neglected issue. This article explains the long genesis of pharmacare, the need for public dental care, and the political circumstances that led to the agreement. However, at this point, details about both plans are largely absent. As a result, how well those plans will serve the needs of Canadians is yet to be determined.
2022年3月,加拿大社会民主党新民主党和中间派自由党政府签署了一项供应与信任协议。作为对新民主党同意在2025年6月之前与政府就所有关键问题进行投票的回报,自由党承诺引入制药和牙科保健项目。医药保健是处方药的全民公共保险,承诺了50多年,但从未实施,而公共牙科保健几乎是一个完全被忽视的问题。这篇文章解释了制药的长期起源,对公共牙科护理的需求,以及导致该协议的政治环境。然而,在这一点上,关于这两项计划的细节基本上都没有。因此,这些计划在多大程度上满足加拿大人的需求尚待确定。
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引用次数: 4
Delayed Access to COVID-19 Vaccines: A Perspective on Low-income Countries in Africa COVID-19疫苗延迟获得:从非洲低收入国家的角度看
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-04-26 DOI: 10.1177/00207314221096365
M. K. Hassan, Sani Aliyu
The development of COVID-19 vaccines was a landmark in the current efforts to contain the global pandemic caused by the novel SARS-CoV-2. Consequently, vaccine rollout and inoculation campaigns continue to progress steadily across the globe. However, “skewed” rollout, or the inequitable or delayed access to the vaccines encountered particularly by low-income countries in Africa, remains a source of great concern. This may negatively affect the continent and could lead to increased transmission, travel restrictions, further economic disruptions, and increased morbidity and mortality. Ultimately, these negative consequences could directly or indirectly hamper global efforts to defeat the pandemic. Access to COVID-19 vaccines is a global priority and provides a source of hope to bring the pandemic under control. High-income nations, national governments, donor agencies, and other relevant stakeholders must support the World Health Organization's COVAX initiative to ensure fair, rapid and equitable distribution of the vaccines to countries, irrespective of income level. This effort will rapidly bring the pandemic under control and impact the recovery of the global economy. Low-income nations in Africa must significantly invest in research, health care, vaccines, and drug development and must remain proactive in preparing against future pandemics. This review examines the rollout of the COVID-19 vaccines with a focus on Africa.
新冠肺炎疫苗的开发是当前遏制新型SARS-CoV-2引起的全球大流行努力的里程碑。因此,疫苗的推广和接种运动在全球范围内继续稳步进展。然而,“倾斜”的推广,或者特别是非洲低收入国家在获得疫苗方面遇到的不公平或延迟,仍然是一个令人严重关切的问题。这可能会对非洲大陆产生负面影响,并可能导致传播增加、旅行限制、经济进一步中断以及发病率和死亡率增加。最终,这些负面后果可能直接或间接阻碍全球战胜疫情的努力。获得新冠肺炎疫苗是全球优先事项,为控制疫情提供了希望。高收入国家、国家政府、捐助机构和其他相关利益攸关方必须支持世界卫生组织的COVAX倡议,以确保向各国公平、快速和公平地分配疫苗,无论收入水平如何。这一努力将迅速控制疫情,并影响全球经济的复苏。非洲低收入国家必须在研究、医疗保健、疫苗和药物开发方面进行大量投资,并必须积极应对未来的流行病。本次审查以非洲为重点,审查新冠肺炎疫苗的推出情况。
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引用次数: 10
The Relation Between Precarious Employment Arrangements and Social Precarity: Findings from the PREMIS Study in Stockholm, Sweden. 不稳定就业安排与社会不稳定的关系:来自瑞典斯德哥尔摩PREMIS研究的结果。
IF 3.4 4区 医学 Q1 Medicine Pub Date : 2022-04-01 Epub Date: 2021-11-24 DOI: 10.1177/00207314211051880
Nuria Matilla-Santander, Johanna Jonsson, Bertina Kreshpaj, Cecilia Orellana, Joan Benach, Kathryn Badarin, Bo Burström, Alejandra Vives, Katarina Kjellberg, Susanne Strömdahl, Gun Johansson, Per-Olof Östergren, Theo Bodin

Precarious employment (PE) is a well-known social determinant of health and health inequalities. However, as most previous studies have focused on physical and mental well-being, less is known about the social-related outcomes (ie, social precarity) associated with precarious arrangements. This cross-sectional study aims to investigate whether PE is associated with social precarity in a working population of 401 nonstandard employed workers in Stockholm, Sweden (2016-2017). PE was assessed with the Swedish version of the Employment Precarious Scale (EPRES-Se) and analyzed in relation to social precarity related to working life (eg, task quality and job security) and living conditions (eg, restraint in social activities and financial constraints). We found positive adjusted associations between quartiles of EPRES-Se and social precarity related to working life (eg, being locked in an occupation [aPRq4:1.33 [1.10-1.61]]) and living conditions (eg, inability to participate in social activities because of work [aPRq4:1.27 [1.10-1.46]]). Our findings suggest that individuals in PE experience social precarity, stressing that PE may have negative effects on well-being. Further studies using multidimensional constructs of PE and larger samples should analyze these findings according to social and policy contexts in order to be able to inform policymakers.

不稳定就业是众所周知的健康和健康不平等的社会决定因素。然而,由于大多数先前的研究都集中在身体和心理健康上,对与不稳定安排相关的社会相关结果(即社会不稳定性)知之甚少。本横断面研究旨在调查瑞典斯德哥尔摩(2016-2017)401名非标准就业工人的工作人口中PE是否与社会不稳定性有关。PE采用瑞典版的就业不稳定量表(epress - se)进行评估,并分析了与工作生活(例如任务质量和工作保障)和生活条件(例如社会活动的限制和财务约束)相关的社会不稳定性。我们发现epress - se四分位数与与工作生活相关的社会不稳定性(例如,被锁定在一种职业中[1.10-1.61]])和生活条件(例如,由于工作而无法参与社会活动[aPRq4:1.27[1.10-1.46]])之间存在正相关。我们的研究结果表明,体育运动的个体经历了社会不稳定性,强调体育运动可能对幸福感有负面影响。为了能够为决策者提供信息,使用PE的多维结构和更大样本的进一步研究应该根据社会和政策背景分析这些发现。
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引用次数: 7
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International Journal of Health Services
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