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To deeply understand the service experience and development expectations of the elderly in nursing homes with integration of medical and nursing in Chongqing so as to provide reference for improving medical-nursing integrated services in nursing homes. We used phenomenological research method and interviewed 16 elderly people from 3 nursing homes with semi-structured in-depth interview, then analyzed the interview data with Colaizzi 7-step analysis method. Four themes were refined, they are construction of living environment, daily living care, medical service provision, psychological support. There are currently many shortcomings in medical-nursing integrated services of nursing homes, which cannot meet the needs of the elderly. Therefore, we recommended the following four measures to improve services so as to increase the satisfaction of the elderly: Firstly, clarify the content of medical services and improve the level of medical services; secondly, increase emotional and social support and establish a psychological counseling department; thirdly, introduce professional talent team in elderly nursing and strengthen knowledge and skills training of carer; fourthly, have a scientific guidance for rational diet and provide diversified diet.

To explore the relations of adolescents externalizing problem behavior to genetic and environmental factors through twin study.The externalizing problem behavior of 66 twin pairs from Chongqing City( aged from 12 to 18years) were investigated with the Youth Self-Report( YSR). The Parenting Styles and Dimensions Questionnaire( PSDQ) and Family Stresses Questionnaire( FSQ), Family Adaptability and Cohesion Scale( FACES) and Stressful Life Event( SLE) were applied to assess their environment factors. The blood sample was collected to identify zygosity oftwins. Structural equation modeling( SEM) was performed to evaluate the relations of adolescents externalizing problem behavior to the additive genetic factors( A), shared environment factors( C) and individual specific environmental factors( E).The effects of A and E on adolescent externalizing problem behavior were 0. 57( 95% CI 0. 37-0. 72) and 0. 43( 95% CI 0. 28-0. 63), respectively. There were significantly negative correlation between externalizing problem behavior and family cohesion( r =-0. 221, P0. 05), the scores of adolescent externalizing problem behavior were positively correlated with the scores of family stresses( r = 0. 226, P0. 05), the scores of stress life events( r = 0. 194, P0. 05), the scores of Authoritarian-parenting-style( r = 0. 235, P0. 05), the scores of Permissive-parenting-style( r = 0. 212, P0. 05). The scores of adolescents externalizing behavioral problems were not significantly correlated with the parenting education level and occupation.Adolescents externalizing problem behavior are influenced by additive genetic factors and individual specific environmental factors. Additive genetic factors play an important role. Family environment and parental rearing-pattern also have correlation with externalizing behavioral problems.

To explore the influence of genetic and environmental factors on adolescents violence behaviors.The violence behaviors of 111 twin pairs from Chongqing (aged from 11 to 18 years) were investigated with risk behavior questionnaire-adolescent (RBQ-A). The Parenting Styles and Dimensions Questionnaire (PSDQ) and Stressful Life Event (SLE) and the General Functioning Scale of the MacMaster Family Activity Device (FAD-GFS) were applied to assess their environment factors. Structural equation modeling was performed to evaluate the effects of the additive genetic factors (A), shared environment factors (C) and individual specific environmental factors (E) on the adolescents violence behaviors.The effects of A and E on adolescents violence behaviors were 0.41 (95% CI 0.19-0.58) and 0.59 (95% CI 0.42-0.81) respectively. There were significantly negative correlation between violence behaviors and authoritative-parenting-style (r = -0.140, P0.05), the score of adolescents violence behaviors was positively correlated with repressive-parenting-style score (r = 0.133, P0.05), the score of adolescents violence behaviors were not significantly correlated with the family functions, stress life events and the parenting education level and occupation.Adolescents violence behaviors were influenced by additive genetic factors and individual specific environmental factors. Environmental plays an important role. It should not been ignored that parental rearing pattern play a role in adolescents violence behaviors.

To explore the influence of genetic and environmental factors on the executive function of twin children.The executive function of 122 twin pairs from Chongqing (aged from 6 to 18 years) were investigated with the perseverative errors of the Wisconsin Card Sorting Test. Structural equation modeling was performed to evaluate the effects of the additive genetic factors (A), dominance genetic latent factors (D) and individual specific environmental factors (E) on the executive functions.The effects of D and E on perseverative errors were 0. 77 (95%CI: 0.65-0.84) and 0.23 (95%CI: 0.16-0.35), respectively. The probability of perseverative errors showed a significant negative correlation with family functioning and with the total GHQ-12 scores of the fathers and mothers (r:-0.335, -0.335, and -0.219, respectively, P0.01). Perseverative errors were not significantly correlated with the parenting styles and stress life events.Perseverative errors are influenced by a common dominance genetic latent factor and individual specific environmental factors, but the role of environmental factors such as family functioning and parental health can not be ignored.