Jane Austin(1775-1817),one of the greatest realistic novelists in English literature,wrote several classical and popular novels,which are the portrayal of the late eighteenth and the early nineteenth centuries,althoug...Jane Austin(1775-1817),one of the greatest realistic novelists in English literature,wrote several classical and popular novels,which are the portrayal of the late eighteenth and the early nineteenth centuries,although with a certain limitation.This paper tries to reveal the social history,the economic realities as well as the women's social statues of Jane Austin's day through her fictions.展开更多
BACKGROUND The prevalence of depressive symptoms in patients undergoing total knee arthroplasty(TKA)ranges from 22%to 26%.The impact of depression on functional status post-TKA remains controversial.AIM To be the firs...BACKGROUND The prevalence of depressive symptoms in patients undergoing total knee arthroplasty(TKA)ranges from 22%to 26%.The impact of depression on functional status post-TKA remains controversial.AIM To be the first study in Latin American population to evaluate the association between depression and functional status one year after TKA,hypothesizing that elderly patients with depression will demonstrate lower rates of functional improvement.METHODS We conducted an observational,descriptive and analytic,retrospective cohort study involving patients over 65 years old who were indicated for TKA.Assessments were made via the Program for Determination and Management of Risks for Practices and Procedures of the Division of Geriatric Medicine at the Italian Hospital of Buenos Aires,between June 2015 and July 2019.Depression screening was conducted using Yesavage’s abbreviated score and Patient Health Questionnaire-9,while functional ability was evaluated using the Knee Society Score(KSS).RESULTS Of the 100 patients analyzed,22(22%)screened positive for depression.The mean age was 80 years±6.3 years,with an average of 77.6 years±6 years in the depressed group and 80.6 years±6.3 years in the non-depressed group(P=0.05).Depressed patients showed significantly greater cognitive impairment[clock-face drawing test median:5(3-6)vs 6(5-7),P=0.06]and more risk factors for confusional syndrome(mean:8±2 vs 6.5±2.2,P=0.006).Frailty was also more prevalent in depressed patients[Edmonton:15(68%)vs 33(42%),P=0.05;Fried:17(77%)vs 42(54%),P=0.05].Postoperative Functional KSS were similar between groups(depressed:65±22.1 vs non-depressed:66.3±20.3,P=0.8).Linear regression analysis revealed no association between depression and changes in KSS.Spearman’s rank correlation coefficients were-0.0304(P=0.8)for Functional KSS variation and-0.1(P=0.3)for KSS variation.CONCLUSION Depression in patients with osteoarthritis should not hinder surgical planning.Identifying and treating depression preoperatively may enhance outcomes such as pain relief and reduce risks of acute confusional syndrome,cognitive impairment,and frailty.展开更多
Background: Hepatitis B virus (HBV) is a primary reason for liver cancer and continues to be a worldwide public health issue. The likelihood of contracting HBV is greater in healthcare workers (HCWs) compared to indiv...Background: Hepatitis B virus (HBV) is a primary reason for liver cancer and continues to be a worldwide public health issue. The likelihood of contracting HBV is greater in healthcare workers (HCWs) compared to individuals who are not in healthcare professions. Medical students are classified as a high-risk demographic since, like HCWs, they often come into contact with bodily fluids and blood during their clinical training. By 2030, a greater proportion of people will have received HBV vaccinations, thereby halting the spread of new infections—The Somali Ministry of Health with the help of various agencies announced to eradicate hepatitis from Somalia. The priority actions are national hepatitis strategy, hepatitis survey, public awareness, training, and capacity building. Objectives: This study aims to assess the knowledge, attitude, and vaccination status of Hepatitis B infection among medical university students in Mogadishu, Somalia, 2024. Methods: Cross-sectional study design was used in this study and the survey was carried out among medical students enrolled in Universities from April 1, 2023 to June 30, 2023. The data was analyzed using SPSS version 26.0 software, Chi-square analysis and Logistic regression analysis to identify associations between demographic factors and HBV knowledge, attitudes, and vaccination status, as well as perspectives and immunization status concerning viral hepatitis. Results: The study achieved a response rate of (96%), with 230 participants. Most students (76.5%) were aged 26 - 30 years, and (60.8%) were male. Nearly half (48.7%) were in their third year of study, and the majority (36.1%) were from the Medicine and Surgery department. While 92.2% had heard of HBV, gaps in understanding were evident. About 37.8% erroneously believed HBV could spread via handshakes, and only 33.9% were aware HBV is treatable. Awareness of HBV’s severe complications, such as liver cirrhosis and liver cancer, was reported by 61.3%, and 83% understood that vaccination could prevent infection. Positive attitudes towards HBV vaccination were prevalent. Most participants (81.3%) supported vaccination before sexual activity, and 78.3% endorsed mandatory HBV vaccination policies for healthcare workers. However, 87.4% expressed concerns about the vaccine promoting unsafe sexual behavior, and 96.1% cited cultural resistance as a barrier to vaccination. A significant proportion (80.86%) of students had not been vaccinated against HBV. Among vaccinated students, 17.4%, 15.7%, and 47.82% had received one, two, and three doses, respectively. Barriers to vaccination included safety concerns (77.4%), lack of time (86.52%), and doubts about efficacy (42.61%). Conclusion: This study highlights gaps in knowledge and vaccination coverage among medical students, which are critical for their health and future clinical practice. Enhancing awareness and vaccination rates can empower students to advocate for preventative measures in their professional environments. Despite high awareness of HBV, knowledge gaps and cultural barriers persist, affecting attitudes and vaccination uptake among medical students. Educational interventions addressing misconceptions, cultural resistance, and vaccine safety are critical. Increased advocacy for mandatory vaccination policies in healthcare settings is also essential to improve HBV prevention methods.展开更多
文摘Jane Austin(1775-1817),one of the greatest realistic novelists in English literature,wrote several classical and popular novels,which are the portrayal of the late eighteenth and the early nineteenth centuries,although with a certain limitation.This paper tries to reveal the social history,the economic realities as well as the women's social statues of Jane Austin's day through her fictions.
文摘BACKGROUND The prevalence of depressive symptoms in patients undergoing total knee arthroplasty(TKA)ranges from 22%to 26%.The impact of depression on functional status post-TKA remains controversial.AIM To be the first study in Latin American population to evaluate the association between depression and functional status one year after TKA,hypothesizing that elderly patients with depression will demonstrate lower rates of functional improvement.METHODS We conducted an observational,descriptive and analytic,retrospective cohort study involving patients over 65 years old who were indicated for TKA.Assessments were made via the Program for Determination and Management of Risks for Practices and Procedures of the Division of Geriatric Medicine at the Italian Hospital of Buenos Aires,between June 2015 and July 2019.Depression screening was conducted using Yesavage’s abbreviated score and Patient Health Questionnaire-9,while functional ability was evaluated using the Knee Society Score(KSS).RESULTS Of the 100 patients analyzed,22(22%)screened positive for depression.The mean age was 80 years±6.3 years,with an average of 77.6 years±6 years in the depressed group and 80.6 years±6.3 years in the non-depressed group(P=0.05).Depressed patients showed significantly greater cognitive impairment[clock-face drawing test median:5(3-6)vs 6(5-7),P=0.06]and more risk factors for confusional syndrome(mean:8±2 vs 6.5±2.2,P=0.006).Frailty was also more prevalent in depressed patients[Edmonton:15(68%)vs 33(42%),P=0.05;Fried:17(77%)vs 42(54%),P=0.05].Postoperative Functional KSS were similar between groups(depressed:65±22.1 vs non-depressed:66.3±20.3,P=0.8).Linear regression analysis revealed no association between depression and changes in KSS.Spearman’s rank correlation coefficients were-0.0304(P=0.8)for Functional KSS variation and-0.1(P=0.3)for KSS variation.CONCLUSION Depression in patients with osteoarthritis should not hinder surgical planning.Identifying and treating depression preoperatively may enhance outcomes such as pain relief and reduce risks of acute confusional syndrome,cognitive impairment,and frailty.
文摘Background: Hepatitis B virus (HBV) is a primary reason for liver cancer and continues to be a worldwide public health issue. The likelihood of contracting HBV is greater in healthcare workers (HCWs) compared to individuals who are not in healthcare professions. Medical students are classified as a high-risk demographic since, like HCWs, they often come into contact with bodily fluids and blood during their clinical training. By 2030, a greater proportion of people will have received HBV vaccinations, thereby halting the spread of new infections—The Somali Ministry of Health with the help of various agencies announced to eradicate hepatitis from Somalia. The priority actions are national hepatitis strategy, hepatitis survey, public awareness, training, and capacity building. Objectives: This study aims to assess the knowledge, attitude, and vaccination status of Hepatitis B infection among medical university students in Mogadishu, Somalia, 2024. Methods: Cross-sectional study design was used in this study and the survey was carried out among medical students enrolled in Universities from April 1, 2023 to June 30, 2023. The data was analyzed using SPSS version 26.0 software, Chi-square analysis and Logistic regression analysis to identify associations between demographic factors and HBV knowledge, attitudes, and vaccination status, as well as perspectives and immunization status concerning viral hepatitis. Results: The study achieved a response rate of (96%), with 230 participants. Most students (76.5%) were aged 26 - 30 years, and (60.8%) were male. Nearly half (48.7%) were in their third year of study, and the majority (36.1%) were from the Medicine and Surgery department. While 92.2% had heard of HBV, gaps in understanding were evident. About 37.8% erroneously believed HBV could spread via handshakes, and only 33.9% were aware HBV is treatable. Awareness of HBV’s severe complications, such as liver cirrhosis and liver cancer, was reported by 61.3%, and 83% understood that vaccination could prevent infection. Positive attitudes towards HBV vaccination were prevalent. Most participants (81.3%) supported vaccination before sexual activity, and 78.3% endorsed mandatory HBV vaccination policies for healthcare workers. However, 87.4% expressed concerns about the vaccine promoting unsafe sexual behavior, and 96.1% cited cultural resistance as a barrier to vaccination. A significant proportion (80.86%) of students had not been vaccinated against HBV. Among vaccinated students, 17.4%, 15.7%, and 47.82% had received one, two, and three doses, respectively. Barriers to vaccination included safety concerns (77.4%), lack of time (86.52%), and doubts about efficacy (42.61%). Conclusion: This study highlights gaps in knowledge and vaccination coverage among medical students, which are critical for their health and future clinical practice. Enhancing awareness and vaccination rates can empower students to advocate for preventative measures in their professional environments. Despite high awareness of HBV, knowledge gaps and cultural barriers persist, affecting attitudes and vaccination uptake among medical students. Educational interventions addressing misconceptions, cultural resistance, and vaccine safety are critical. Increased advocacy for mandatory vaccination policies in healthcare settings is also essential to improve HBV prevention methods.
