China is encountering formidable healthcare challenges brought about by the problem of aging. By 2050, there will be 400 million Chinese citizens aged 65+, 150 million of whom will be 80+. The undesirable consequences of the one-child policy, rural-to-urban migration, and expansion of the population of ‘empty nest ’ elders are eroding the traditional family care of the elders, further exacerbating the burden borne by the current public healthcare system. The challenges of geriatric care demand prompt attention by proposing strategies for improvement in several key areas. Major diseases of the elderly that need more attention include chronic non-communicable diseases and mental health disorders. We suggest the establishment of a home care-dominated geriatric care system, and a proactive role for researchers on aging in reforming geriatric care through policy dialogs. We propose ideas for preparation of the impending aging burden and the creation of a nurturing environment conducive to healthy aging in China.

Migrants are at greater risk for HIV infection than the general Chinese population and likely to facilitate the geographical spread of HIV in China. Targeted strategies for health promotion and HIV prevention for migrants in China should be developed.

BackgroundSense of Coherence (SOC) is considered as a health-promoting resource; it is mainly developed before the age of 30. The multiple demands university students face, such as study-related stress and financial difficulty, could challenge their SOC development. This study aimed to: 1) investigate the association between SOC, socio-demographic and lifestyle-related characteristics; 2) assess the effect of perceived stress on SOC controlling for other variables among the Chinese university students. Analyses were done to derive a better view on possible strategies to strengthen students’ SOC and with that to promote their health.MethodsThe data used were from a Chinese university student health survey (N = 1,853). Logistic regression analyses were used to explore the effects of varied socio-demographic, lifestyle-related variables on students’ level of SOC, as well as the association between perceived stress and SOC controlling for other variables in the analysis.ResultsBoth social support (OR = 2.56 [1.87–3.50]) and better performance compared with peers (OR = 1.64 [1.15–2.34]) were associated with a stronger SOC. Not feeling isolated at university (OR = 1.60 [1.04–2.47]) and satisfaction with the political situation (OR = 2.05 [1.57–2.67]) were also associated with a stronger SOC. This counts also for high health awareness (OR = 1.40 [1.05–1.87]) and nutrition importance (OR = 1.67 [1.04–2.69]). Perceived stress (OR = 0.81 [0.79–0.83]) was negatively associated with a strong SOC when controlling for socio-demographic and lifestyle-related variables.ConclusionWe suggest integrating stress coping, emotion management training programmes as well as measures promoting social integration for students and teachers at campus, promoting healthy behaviours, and creating a supportive learning environment as strategies for enhancing the SOC level of university students in China.

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Methadone maintenance treatment (MMT) has become an important modality of substitution treatment for opioid addicts in China since 2006. However, data are limited regarding the change in sexual function from heroin use to MMT and the influence of sexual dysfunction (SD) during MMT on patient's life and treatment. Face-to-face in-depth interviews were conducted with 13 male and 14 female MMT patients, five of their partners, and three clinicians. The interviews took place in four MMT clinics in Guangdong Province between August 2010 and February 2011. The patients and their partners were asked separately for their perceptions of patient's sexual function during MMT, and the influence of SD on personal/family life and treatment. The main SD problems patients perceived were libido inhibition and decreased sexual pleasure. Methadone was thought to have a stronger inhibition effect on sexual desire than heroin. SD decreased quality of patient's sexual life and damaged intimate relationships. There was a gender difference in coping with SD. Men generally tended to refuse, escape, or alienate their partners. Women tended to hide sexual listlessness, endure sexual activity and tried to satisfy their partners. SD might increase risk of voluntary dropout from treatment and illicit drug use during treatment. Patients with SD did not get any effective therapy from clinicians and they also lacked skills on coping with SD-related problems. Sexual dysfunction prevented patients from reconstructing a normal intimate relationship, and affected stability of maintenance treatment. Response to patient's SD and SD-related problems from clinicians was inadequate. There is a need to develop a clinical guide to deal with both SD itself and SD-related problems.

BackgroundTo complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010.MethodsTo estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted.ResultsIn 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were “trachea, bronchus and lung cancers”, “ischaemic heart disease” and “lower respiratory infections” together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong’s standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional) conditions showed highest increases with SEYLL-rates per 100,000 in 2010 being 1.4 times higher than 2001.ConclusionsThe study stresses the mortality impact of diseases and injuries that occur in earlier stages of life and thus presents the SEYLL measure as a more sensitive indicator compared to classical mortality indicators. SEYLL provide useful additional information and supplement available death statistics.

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The results support the primary role of retroposition of the mandible in the development of cardinal symptoms of Pierre Robin Sequence.