Sex tourism among Chinese men who have sex with men: a cross-sectional observational study.

BACKGROUND: Sex tourism among men who have sex with men (MSM) may exacerbate transmission of HIV and other sexually transmitted infections (STIs). Sex tourism is defined as purchasing sex with gifts or money outside of one's hometown. Our objective was to characterize the frequency, socio-demographic characteristics, and sexual risk behaviors among Chinese MSM sex tourists. METHODS: An online, cross-sectional survey for high-risk MSM throughout China was conducted in November 2015 covering sociodemographic characteristics, sexual risk behaviors, and sex tourism. Univariate and multivariable logistic regressions were performed to identify correlates of sex tourism. The mean MSM HIV prevalence of sex tourism journey origins and destinations were compared. RESULTS: Of 1189 MSM who completed the survey, 62 (5%) men identified as sex tourists; among these sex tourists, twenty (32%) traveled primarily to purchase sex and the remainder purchased sex while traveling for another purpose. There was minimal socio-demographic and behavioral difference between the two groups. In multivariable analyses, adjusting for age and income, sex tourism was correlated with high-risk sexual behaviors, higher income (aOR 4.44, 95%CI 1.77-11.18) and living with HIV (aOR 2.79, 95%CI 1.03-7.55). Sex tourism was more often from locations with lower to higher MSM HIV prevalence (mean = 4.47, SD = 2.01 versus mean = 6.86, SD = 5.24). CONCLUSION: MSM sex tourists were more likely to have risky sexual behaviors and travel to locations with a higher HIV prevalence. MSM sex tourists may be part of core groups that are disproportionately responsible for MSM HIV transmission. Enhanced surveillance and interventions tailored to MSM sex tourists should be considered

Prevalence and influencing factors of chronic pain in middle-aged and older adults in China: results of a nationally representative survey

BackgroundWith China's rapidly aging population, chronic pain has become a major public health issue. This article aims at determining associations between chronic pain and multiple factors, including demographic characteristics, health status, and health service utilization of middle-aged and older adults in China.MethodsWe selected all the 19,829 respondents who were over 45 years old from the China Health and Aging Tracking Survey 2018 (CHARLS) as our study population. The key information in terms of the body pain, demographic characteristics, health status, behaviors and health services use was extracted and analyzed. Logistic regression model was used to determine the influencing factors of chronic pain.ResultsAnalysis revealed that 60.02% (9,257) of the data from this survey reported physical pain, with pain sites concentrated at the head (40.9%), lower back (62.2%) and knees (47.2%). Pain was positively associated with influencing factors for pain: being a female (OR = 2.10, 95% CI 1.90–2.33, p < 0.001), living in a western region (OR = 1.28, 95% CI 1.16–1.41, p < 0.001), living in a rural area (OR = 1.14, 95% CI 1.06–1.23, p < 0.001), smoked (OR = 1.26, 95% CI 1.14–1.38, p < 0.001), drank alcohol (OR = 1.16, 95% CI 1.06–1.26, p = 0.001), and had poor self-rated health (OR = 6.84, 95% CI 5.41–8.65, p < 0.001), had hearing problems (OR = 1.23, 95% CI 1.11–3.37, p < 0.001), were depressed (OR = 1.56, 95% CI 1.03–1.29, p < 0.001), had arthritis (OR = 2.21, 95% CI 2.02–2.41, p < 0.001), stomach disorders (OR = 1.69, 95% CI 1.55–1.85, p < 0.001), visited a Western medicine hospital (OR = 1.28, 95% CI 1.10–1.50, p = 0.002), and visits to other medical institutions (OR = 1.42, 95%CI 1.22–1.64, p < 0.001). On the other side, as a protective factor for pain, having nighttime sleep ≥7 h (OR = 0.74, 95%CI 0.68–0.80, p < 0.001) was negatively associated with pain.ConclusionPhysical pain affects many older adults. Women, regional, rural residents, smokers, alcohol drinkers, people with poor self-rated health, those having <7 h of sleep at night, those with hearing problems, depression, arthritis, stomach disorders, and people who visits Western hospitals or other medical institutions are at greater risk for pain and deserve the attention of health care providers and policy makers to focus on pain prevention and management in middle-aged and older adults. Future research studies should also focus on the impact of health literacy on pain prevention and management outcomes

Nonrigid Registration of Monomodal MRI Using Linear Viscoelastic Model

This paper describes a method for nonrigid registration of monomodal MRI based on physical laws. The proposed method assumes that the properties of image deformations are like those of viscoelastic matter, which exhibits the properties of both an elastic solid and a viscous fluid. Therefore, the deformation fields of the deformed image are constrained by both sets of properties. After global registration, the local shape variations are assumed to have the properties of the Maxwell model of linear viscoelasticity, and the deformation fields are constrained by the corresponding partial differential equations. To speed up the registration, an adaptive force is introduced according to the maximum displacement of each iteration. Both synthetic datasets and real datasets are used to evaluate the proposed method. We compare the results of the linear viscoelastic model with those of the fluid model on the basis of both the standard and adaptive forces. The results demonstrate that the adaptive force increases in both models and that the linear viscoelastic model improves the registration accuracy

Examining the impact of chronic diseases on activities of daily living of middle-aged and older adults aged 45 years and above in China: a nationally representative cohort study

BackgroundChina has by far one of the fastest-aging populations in the world. Increasing age is often accompanied by an increasing prevalence of chronic diseases and impaired Activities of Daily Living (ADL). The aim of this study was to analyze the effects of chronic diseases on ADL in Chinese middle-aged and older adults and to provide a scientific basis for delaying the impairment of ADL and prolonging the self-care life expectancy of middle-aged and older adults.MethodsThis investigation utilized the survey information of 10,096 middle-aged and older adults from the China Health and Aging Tracking Survey (CHARLS) of 2011 as baseline data, then followed up this cohort until 2018, and performed multifactorial analyses using Cox proportional risk models to explore the strength of the associations between chronic diseases and the risk of impaired ADL in middle-aged and older adults.ResultsAmong the middle-aged and older adult population, the presence of hypertension was associated with a 38% higher risk of impaired ADL compared to those without the condition (HR = 1.38,95% CI:1.24–1.54); the involvement of heart disease was associated with a 27% higher risk of impaired ADL compared to those without the condition (HR = 1.27,95% CI:1.10- 1.46); the existence of arthritis was associated with a 38% higher risk of impaired ADL in middle-aged and older adults compared to those without arthritis (HR = 1.38,95% CI:1.25–2.08); additionally, the risk of impaired ADL with one or ≥ 2 chronic diseases was increased by 34% (HR = 1.34, 95% CI:1.18–1.52) and 84% (HR = 1.84, 95% CI:1.63–2.08) in middle-aged and older adult individuals, respectively.ConclusionHypertension is a risk factor for impaired ADL at any age in the subjects of this study. Examining the association between the number of chronic diseases and impairment in activities of daily living, it was revealed that the risk of ADL impairment increased with the number of chronic diseases in both the middle-aged (45–59 years) and older adult (60–74 years) groups

An analysis of socioeconomic factors on multiple chronic conditions and its economic burden: evidence from the National Health Service Survey in Yunnan Province, China

BackgroundThe economic burden of multiple chronic conditions (MCCs) and its socio-economic influencing factors have widely raised public concerns. However, there are few large population-based studies on these problems in China. Our study aims at determining the economic burden of MCCs and associated factors specific to multimorbidity among middle-aged and older individuals.MethodsAs our study population, we extracted all 11,304 participants over 35 years old from the 2018 National Health Service Survey (NHSS) in Yunnan. Economic burden and socio-demographic characteristics were analyzed with descriptive statistics. Chi-square test and generalized estimating equations (GEE) regression models were used to identify influencing factors.ResultsThe prevalence of chronic diseases was 35.93% in 11,304 participants and the prevalence of MCCs increased with age, was 10.12%. Residents who lived in rural areas were more likely to report MCCs than those who lived in urban areas (adjusted OR = 1.347, 97.5% CI: 1.116–1.626). Ethnic minority groups were less likely to report MCCs than those of Han (OR = 0.752, 97.5% CI: 0.601–0.942). Overweight or obese people were more likely to report MCCs than people with normal weight (OR = 1.317, 97.5% CI: 1.099–1.579). The per capita expenses of 2 weeks’ illness, per capita hospitalization expenses, annual household income, annual household expenses, and annual household medical expenses of MCCs were ¥292.90 (±1427.80), ¥4804.22 (±11851.63), ¥51064.77 (±52158.76), ¥41933.50 (±39940.02) and ¥11724.94 (±11642.74), respectively. The per capita expenses of 2 weeks’ illness, per capita hospitalization expenses, annual household income, annual household cost, and annual household medical expenses of hypertensive co-diabetic patients were more compared to those with other three comorbidity modes.ConclusionThe prevalence of MCCs was relatively high among middle-aged and older individuals in Yunnan, China, which bought a heavy economic burden. This encourages policy makers and health providers to pay more attention to the behavioral/lifestyle factors, that contribute to multimorbidity to a great extent. Furthermore, health promotion and education in terms of MCCs need to be prioritized in Yunnan