Objective In 2006,Alzheimer's Association Victoria Australia funded the authors to conduct a systematic review of the community education literature in order to assist the development of their own community educat...Objective In 2006,Alzheimer's Association Victoria Australia funded the authors to conduct a systematic review of the community education literature in order to assist the development of their own community education strategy.Methods This paper draws upon this research project to convey the predominant messages arising consistently across the evidence base relating to key national health priority areas.Particular attention is given to exploring the needs of minority groups.Results The evidence reviewed indicates the need for multi-faceted intervention approaches that are carefully planned and assessed to ensure sufficient exposure of the target audience to the health messages.Conclusion Such approaches remain to be empirically tested within the context of dementia risk reduction.Nevertheless,there are consistent models in the evidence base that can be applied with confidence to community education in the current domain.展开更多
Water availability in sub-Saharan Africa is increasingly threatened by rapid land use and land cover(LULC)changes,particularly within ecologically sen-sitive areas which are potential areas providing vital hydrologica...Water availability in sub-Saharan Africa is increasingly threatened by rapid land use and land cover(LULC)changes,particularly within ecologically sen-sitive areas which are potential areas providing vital hydrological services,and supporting high biodiversity and varieties of ecosystem services.This study as sessed spatial and temporal LULC changes,their underlying drivers,and po-tential community-based interventions in the Kidunda River Catchment,a key upstream area within Tanzania’s Wami-Ruvu Basin where the Kidunda Dam is planned to enhance downstream water supply.Using Landsat imagery from 1994,2005,2016,and 2024,supervised classification with Random Forest al gorithms was applied to detect LULC transitions.Results revealed a significant decline in forest(60.11%)and wetland(68.75%)cover,accompanied by a sub-stantial expansion of cultivated land(226.82%)and built-up areas(196.03%).The most dominant conversion pathways were woodland and wetland to cul-tivated land,indicating intense anthropogenic pressure.Qualitative data from focus group discussions and key informant interviews identified population growth,agricultural expansion,and weak enforcement as key drivers of change.However,a slight slowdown in LULC transformation observed after 2016 co incided with the gazettement of Nyerere National Park,suggesting that policy interventions can yield positive outcomes.Community-driven solutions such as participatory land use planning,agroforestry,and soil and water conservation were highlighted as effective strategies for landscape restoration and water security.The findings underscore the urgent need for integrated catchment man-agement and localized interventions to safeguard the ecological functions of the catchment and ensure the long-term sustainability of the Kidunda Dam and downstream water supplies.展开更多
In 2012,an estimated 35.3 million people lived with HIV,while approximately two million new HIV infections were reported.Community-based interventions(CBIs)for the prevention and control of HIV allow increased access ...In 2012,an estimated 35.3 million people lived with HIV,while approximately two million new HIV infections were reported.Community-based interventions(CBIs)for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk,or already infected with,HIV.This paper evaluates the impact of CBIs on HIV knowledge,attitudes,and transmission.We included 39 studies on educational activities,counseling sessions,home visits,mentoring,women’s groups,peer leadership,and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence.Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge,attitudes,and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS(SMD:0.66,95%CI:0.25,1.07),protected sexual encounters(RR:1.19,95%CI:1.13,1.25),condom use(SMD:0.96,95%CI:0.03,1.58),and decreased frequency of sexual intercourse(RR:0.76,95%CI:0.61,0.96).Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication.We found very limited evidence on community-based management for HIV infected population and prevention of mother-to-child transmission(MTCT)for HIV-infected pregnant women.Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement.School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group.Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT,and various emerging models of care to improve morbidity and mortality outcomes.展开更多
In this paper,we aim to evaluate the effectiveness of community-based interventions(CBIs)for the prevention and management of malaria.We conducted a systematic review and identified 42 studies for inclusion.Twenty-fiv...In this paper,we aim to evaluate the effectiveness of community-based interventions(CBIs)for the prevention and management of malaria.We conducted a systematic review and identified 42 studies for inclusion.Twenty-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets(ITNs),indoor residual spraying(IRS),or impregnated bed sheets;14 studies evaluated intermittent preventive therapy(IPT)delivered in community settings;two studies focused on community-based education for malaria prevention;and one study evaluated environmental management through drain cleaning.Our analysis suggests that,overall,the community-based delivery of interventions to prevent and control malaria resulted in a significant increase in ITNs ownership(RR:2.16,95%CI:1.86,2.52)and usage(RR:1.77,95%CI:1.48,2.11).However,usage of ITNs was limited to two-thirds of the population who owned them.Community-based strategies also led to a significant decrease in parasitemia(RR:0.56,95%CI:0.42,0.74),malaria prevalence(RR:0.46,95%CI:0.29,0.73),malaria incidence(RR:0.70,95%CI:0.54,0.90),and anemia prevalence(RR:0.79,95%CI:0.64,0.97).We found a non-significant impact on splenomegaly,birth outcomes(low birth weight,prematurity,stillbirth/miscarriage),anthropometric measures(stunting,wasting,and underweight),and mortality(all-cause and malaria-specific).The subgroup analysis suggested that community-based distribution of ITNs,impregnated bed sheets and IRS,and IPT are effective strategies.Qualitative synthesis suggests that high coverage could be achieved at a lower cost with the integration of CBIs with existing antenatal care and immunization campaigns.Community-based delivery of interventions to prevent and control malaria are effective strategies to improve coverage and access and reduce malaria burden,however,efforts should also be concerted to prevent over diagnosis and drug resistance.展开更多
In this paper,we aim to systematically analyze the effectiveness of community-based interventions(CBIs)for the prevention and control of helminthiasis including soil-transmitted helminthiasis(STH)(ascariasis,hookworms...In this paper,we aim to systematically analyze the effectiveness of community-based interventions(CBIs)for the prevention and control of helminthiasis including soil-transmitted helminthiasis(STH)(ascariasis,hookworms,and trichuriasis),lymphatic filariasis,onchocerciasis,dracunculiasis,and schistosomiasis.We systematically reviewed literature published before May 2013 and included 32 studies in this review.Findings from the meta-analysis suggest that CBIs are effective in reducing the prevalence of STH(RR:0.45,95%CI:0.38,0.54),schistosomiasis(RR:0.40,95%CI:0.33,0.50),and STH intensity(SMD:−3.16,95 CI:−4.28,−2.04).They are also effective in improving mean hemoglobin(SMD:0.34,95%CI:0.20,0.47)and reducing anemia prevalence(RR:0.90,95%CI:0.85,0.96).However,it did not have any impact on ferritin,height,weight,low birth weight(LBW),or stillbirths.School-based delivery significantly reduced STH(RR:0.49,95%CI:0.39,0.63)and schistosomiasis prevalence(RR:0.50,95%CI:0.33,0.75),STH intensity(SMD:−0.22,95%CI:−0.26,−0.17),and anemia prevalence(RR:0.87,95%CI:0.81,0.94).It also improved mean hemoglobin(SMD:0.24,95%CI:0.16,0.32).We did not find any conclusive evidence from the quantitative synthesis on the relative effectiveness of integrated and non-integrated delivery strategies due to the limited data available for each subgroup.However,the qualitative synthesis from the included studies supports community-based delivery strategies and suggests that integrated prevention and control measures are more effective in achieving greater coverage compared to the routine vertical delivery,albeit it requires an existing strong healthcare infrastructure.Current evidence suggests that effective community-based strategies exist and deliver a range of preventive,promotive,and therapeutic interventions to combat helminthic neglected tropical diseases(NTDs).However,there is a need to implement and evaluate efficient integrated programs with the existing disease control programs on a larger scale throughout resource-limited regions especially to reach the unreachable.展开更多
BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant dispa...BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.展开更多
Objective:To analyze the effect of interventional nursing on the therapeutic effect,negative emotion and quality of life of patients undergoing cardiovascular and cerebrovascular interventional therapy.Methods:Eighty-...Objective:To analyze the effect of interventional nursing on the therapeutic effect,negative emotion and quality of life of patients undergoing cardiovascular and cerebrovascular interventional therapy.Methods:Eighty-four patients who received cardio-cerebral vascular interventional therapy in a hospital during January 2024–December 2024 were selected,and were divided into the control group and the observation group by the mean score method,each with 42 cases.The control group was given standardized perioperative care,and the observation group was given interventional nursing intervention on this basis.The two groups were compared in terms of clinical efficacy,negative emotion score,incidence of related complications,quality of life score and nursing satisfaction.Results:The total effective rate of treatment of patients in the observation group(95.24%)was significantly higher than that of the control group(78.57%),and the difference was statistically significant(P<0.05);before nursing care,the difference between SDS and SAS scores of patients in the two groups was insignificant(P>0.05);after nursing care,the scores of various indexes of the two groups were significantly reduced and the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05);the patients in the observation group had more negative moods than those in the control group;the complication rate of patients in the observation group(2.38%)was significantly lower than that of the control group(19.04%),and the difference was statistically significant(P<0.05);the quality of life scores of patients in the observation group were higher than that of the control group,and the difference was statistically significant(P<0.05);the satisfaction rate of patients’nursing care in the observation group was 97.62%,which was higher than that of the control group(78.57%),and the difference was statistically significant(P<0.05).The difference is statistically significant(P<0.05).Conclusion:The implementation of interventional nursing intervention for patients with cardiovascular and cerebrovascular interventional therapy can further enhance the clinical therapeutic effect,improve the negative emotions of patients’anxiety and depression,reduce the risk of related complications,improve the quality of life of patients,and obtain higher satisfaction.展开更多
There have been an increasing number of studies on climate change and population health over the past 20 years,with most focusing on health risk assessment,targeting different locations and populations with various di...There have been an increasing number of studies on climate change and population health over the past 20 years,with most focusing on health risk assessment,targeting different locations and populations with various diseases[1−2].While these studies have provided the necessary epidemiological evidence for health authorities in policymaking,it is time to develop and implement tailored health interventions to protect the health and well-being of communities,and particularly that of vulnerable groups.展开更多
Psychological interventions have demonstrated efficacy in improving patients’emotional state,cognition,and thinking abilities,thereby enhancing their quality of life and survival.This review examines literature from ...Psychological interventions have demonstrated efficacy in improving patients’emotional state,cognition,and thinking abilities,thereby enhancing their quality of life and survival.This review examines literature from the China National Knowledge Infrastructure,Wanfang Data,Web of Science,and PubMed databases published over the past decade,focusing on the use of psychotherapy for poststroke anxiety and depression.The prevalence of anxiety and depression is significantly higher among patients who have experienced a stroke than in the general population,possibly due to vestibular dysfunction following brain injury.Current psychological interventions for stroke patients include cognitive behavioral therapy,supportive psychotherapy,music and art therapy,and exercise therapy.These approaches have been shown to promote psychological wellbeing and physical rehabilitation.展开更多
Depression is a common and serious mental disorder,triggered by multiple biological,social and psychological factors.According to the World Health Organization,the incidence of suicide in patients with depression is m...Depression is a common and serious mental disorder,triggered by multiple biological,social and psychological factors.According to the World Health Organization,the incidence of suicide in patients with depression is much higher than in patients with other mental illnesses.Depression has a complex etiology and individual differences,and the effect of single therapy is limited.This review classifies depression into endogenous,exogenous,and secondary categories based on etiology,describes their characteristics,and reviews the research progress of psychological,pharmacological,traditional Chinese medicine,and microbiological interventions.Studies have shown that about 30%-50%of depression has a genetic predisposition;cognitive behavioral therapy is effective for patients with mild-to-moderate depression,and has significant advantages in preventing recurrence,such as networked cognitive behavioral therapy,which is effective in improving mild-to-moderate depressive symptoms,and has a high level of user experience and adherence.Diets rich in dietary fiber,Omega-3 fatty acids,and supplementation with specific probiotics such as Bifidobacterium and Lactobacillus can help alleviate depressive symptoms;preparations of Chinese herbal compounds derived from the Chinese herbal formula,Xiaoyaosan,are effective in alleviating depressive behaviors in mice;and acupuncture is helpful in alleviating primary depression,especially in milder cases.Taken together,gut microbiota influence brain changes through the gut-brain axis.Chinese medicine can realize the combination of Chinese and Western medicine.Both gut microbiota and Chinese medicine show great potential in the treatment of depression.However,the specific therapeutic mechanisms need to be further investigated.展开更多
Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chines...Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.展开更多
Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CIN...Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CINAHL,and Web of Science were systematically searched for this network meta-analysis.Randomized controlled studies(RCTs)that included children aged 4-12 years with no physical or mental conditions;performed at least 1 type of lifestyle intervention;reported change in body mass index(BMI),BMI z-score,or body fat percentage(BFP);and were published between January2010 and August 2023 were included.Results:The final analysis included 91 RCTs with aggregate data for 58,649 children.All interventions were categorized into single-arm approaches(physical activity,diet,and behavioral and informational support)and combined arms approaches(bicomponent and multicomponent treatment).Multicomponent treatment showed significant effectiveness on the reduction of BMI(mean deviation(MD)-0.49,95%confidence interval(95%CI):-0.88 to-0.12),BMI z-score(MD=-0.11,95%CI:-0.18 to-0.04),and BFP(MD=-1.69,95%CI:-2.97 to-0.42)compared to the usual care condition.Bicomponent treatment also significantly reduced BMI(MD=-0.28,95%CI:-0.54 to-0.04)and BMI z-score(MD=-0.07,95%CI:-0.12 to-0.02)compared to usual care.Conclusion:Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP.Among single-component approaches,physical activity engagement emerged as the most effective.These findings should guide practitioners in recommending comprehensive lifestyle modifications for children.Moreover,children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.展开更多
BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidel...BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.展开更多
Objective: To assess the impact of preoperative psychological interventions on the care of patients undergoing elective surgery. Methods: Ninety-two patients scheduled for elective surgery in the surgical department b...Objective: To assess the impact of preoperative psychological interventions on the care of patients undergoing elective surgery. Methods: Ninety-two patients scheduled for elective surgery in the surgical department between August 2021 and August 2023 were selected and divided into groups using a random number table. The observation group received preoperative psychological interventions, while the reference group received standard preoperative care. Anxiety and depression scores, fear grading, vital signs, and self-efficacy levels were compared. Results: After the intervention, the anxiety and depression scores in the observation group were lower than those in the reference group, and the proportion of fear graded as Level I was higher. During the waiting period and 15 minutes before entering the operating room, vital sign levels in the observation group were lower than those in the reference group. Additionally, the self-efficacy scores of the observation group were significantly higher than those of the reference group (P < 0.05). Conclusion: Preoperative psychological interventions can alleviate negative emotions, stabilize preoperative vital signs, and significantly improve self-efficacy in patients undergoing elective surgery, demonstrating high feasibility for implementation.展开更多
The initiation and progression of colorectal cancer(CRC)are profoundly influenced by the complex interplay between the gut microbiota and the immune system,underscoring the clinical importance of exploring the bidirec...The initiation and progression of colorectal cancer(CRC)are profoundly influenced by the complex interplay between the gut microbiota and the immune system,underscoring the clinical importance of exploring the bidirectional regulatory mechanisms of the microbiota-immune axis within the CRC immune microenvironment.Emerging evidence indicates that the composition and functional capacity of the gut microbiota play a vital role in modulating the host’s immune responses,while the immune system,in turn,can reciprocally regulate the structure and function of the microbiota.Despite significant insights into the role of the microbiota-immune axis in CRC progression,several critical questions remain unanswered-including how microbial heterogeneity affects therapeutic outcomes and the specific consequences of dysregulated regulatory mechanisms on the immune microenvironment.This review aims to provide a comprehensive analysis of the compositional features of the CRC immune microenvironment,examine the bidirectional molecular mechanisms underpinning the microbiotaimmune axis,and evaluate the potential of targeted therapeutic strategies,thereby offering novel research perspectives and clinical applications for CRC treatment.展开更多
Background Exercise during neoadjuvant chemoradiotherapy(NCRT)has potential to mitigate treatment-related declines in physical fitness,and to improve clinical outcomes,including toxicity and tumor response.However,opt...Background Exercise during neoadjuvant chemoradiotherapy(NCRT)has potential to mitigate treatment-related declines in physical fitness,and to improve clinical outcomes,including toxicity and tumor response.However,optimal frequency and timing of exercise remains to be determined.Therefore,this pilot trial aimed to assess feasibility of 2 different exercise interventions during NCRT in patients with esophageal and rectal cancer and to evaluate potential clinical effects.Methods Patients were randomized into 1 of 3 study arms during NCRT:(a)30-min aerobic exercise in-hospital within 1 h prior to each radiotherapy fraction(ExPR),(b)two 60-min supervised combined aerobic and resistance exercise sessions per week(AE+RE),and(c)usual care(UC).Feasibility was assessed by examining participation rate and exercise adherence.Intervention effects on physical fitness,health-related quality of life,treatment-related toxicity,and tumor response in patients with esophageal cancer were explored using regression analyses and 85%confidence intervals(85%CIs).Results Thirty-seven patients with esophageal cancer(participation rate=45%)and 2 patients with rectal cancer(participation rate=14%)were included.Median session attendance was 98%(interquartile range(IQR):96%–100%)in the ExPR and 78%(IQR:33%–100%)in the AE+RE group.We found clinically relevant benefits of exercise on maximal oxygen uptake(VO2_(max),mL/kg/min)(ExPR:β=9.7,85%CI:6.9–12.6;AE+RE:β=5.6,85%CI:2.6–8.5)and treatment-related toxicity(ExPR:β=–2.8,85%CI:–5.4 to–0.2;AE+RE:β=–2.6,85%CI:–5.3 to 0.0).Additionally,good tumor response was found in 70%in AE+RE and ExPR vs.55%in UC(odds ratio(OR)=1.9,85%CI:0.5–7.7).Conclusion Starting prehabilitation during NCRT is feasible,can increase starting fitness of traditional pre-surgical programs,and has potential to improve clinical outcomes.展开更多
Cancer significantly impacts patients'physical and mental health,leading to a wide range of effects from physical pain to psychological issues such as anxiety and depression,severely diminishing their quality of l...Cancer significantly impacts patients'physical and mental health,leading to a wide range of effects from physical pain to psychological issues such as anxiety and depression,severely diminishing their quality of life.As an emerging psychosomatic intervention,mindfulness interventions have gained increasing attention.This scoping review systematically searches and filters relevant literature,covering databases from their inception to January 2025,aiming to comprehensively outline the application,research characteristics,and main outcomes of mindfulness interventions in cancer recovery.We employed the Arksey and O'Malley framework,utilizing electronic databases and manual searches to rigorously select studies and extract key data.Results indicate that mindfulness interventions show broad potential in improving cancer patients'mental health,physical symptoms,and quality of life,despite the heterogeneity of the evidence.Future research should focus on higher-quality randomized controlled trials to explore different intervention modalities and long-term effects and to analyze their underlying mechanisms.This paper particularly highlights the advancements in Mindfulness-Based Cancer Recovery,providing valuable references for clinical practice.展开更多
Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disord...Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disorders is extremely complex,with a wide spectrum of biological,psychological,and sociocultural factors being responsible for their appearance and development.In this sense,immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders,worsening mainly the central nervous system(neuroinflammation)and the periphery of the body(systemic inflammation).However,these alterations cannot be understood separately,but as part of a complex picture in which different factors and systems interact with each other.Psychoneuroimmunoendocrinology(PNIE)is the area responsible for studying the relationship between these elements and the impact of mind–body integration,placing the immune system as part of a whole.Thus,the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche,damage to the nervous system,alterations to the endocrine and metabolic systems,and disruption of the microbiota and intestinal ecosystem,as well as of other organs and,in turn,all these mechanisms are responsible for inducing and enhancing the immune dysfunction.Similarly,the clinical approach to these patients is usually multidisciplinary,and the therapeutic arsenal includes different pharmacological(for example,antidepressants,antipsychotics,and lithium)and non-pharmacological(i.e.,psychotherapy,lifestyle,and electroconvulsive therapy)treatments.These interventions also modulate the immune system and other elements of the PNIE in these patients,which may be interesting to understand the therapeutic success or failure of these approaches.In this sense,this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE.Likewise,an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients,in order to identify the mechanisms described and their possible uses as biomarkers.展开更多
Objective:This scoping review explores digital health interventions used to improve maternal health and the health of children under-5-year-olds in rural areas of low-and middle-income countries(LMICs),identifying cur...Objective:This scoping review explores digital health interventions used to improve maternal health and the health of children under-5-year-olds in rural areas of low-and middle-income countries(LMICs),identifying current practices and research gaps.Methods:Guided by PRISMA Extension for Scoping Reviews,a comprehensive search was conducted across PubMed,Web of Science,and grey literature search with Google Scholar,and the South African National Elec-tronic Theses and Dissertations Portal.MeSH terms and Boolean operators were used.Studies were screened using the Population,Concept,and Context framework,and data were extracted systematically.Results:Of 5,114 records,63 met inclusion criteria.Digital health interventions,particularly mobile health,were found to enhance service delivery,education,and support for maternal and child health in LMICs.However,challenges such as limited access to technology,digital literacy,and cultural barriers persist.Contextual factors,including geography and sociocultural norms,significantly influenced implementation success.Conclusion:Digital health interventions show promise in improving maternal and child health in LMICs.How-ever,regional disparities,technological limitations,and cultural misalignment hinder scalability.Future research should focus on culturally adaptive,community-engaged approaches and long-term impact assessments to sup-port sustainable health promotion in low-resource settings.展开更多
Objective:To assess the method of empathy intervention in nursing students in relation to the three dimensions of empathy:cognitive,affective,and behavioral.Methods:A systematic literature review was conducted followi...Objective:To assess the method of empathy intervention in nursing students in relation to the three dimensions of empathy:cognitive,affective,and behavioral.Methods:A systematic literature review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guideline.A search for articles in two databases(ScienceDirect and Taylor&Francis)revealed 99 articles.One author independently assessed articles for inclusion,resulting in 10 articles that met the inclusion criteria.Results:Based on a review of ten extracted journal articles,nine interventions showed increases in empathy,while one intervention did not show such outcomes.Four studies(the simulation-based empathic communication training intervention,the situated teaching program,high-fidelity simulation[HFS]training,and the structured empathy educational model[EEM])discussed the impact of interventions on the empathy dimension,while the remaining five only explained the impact of the intervention on empathy in general.Conclusions:The result of this study highlight the need for future research to design empathy interventions for nursing students that effectively target both the affective and behavioral dimensions of empathy.展开更多
文摘Objective In 2006,Alzheimer's Association Victoria Australia funded the authors to conduct a systematic review of the community education literature in order to assist the development of their own community education strategy.Methods This paper draws upon this research project to convey the predominant messages arising consistently across the evidence base relating to key national health priority areas.Particular attention is given to exploring the needs of minority groups.Results The evidence reviewed indicates the need for multi-faceted intervention approaches that are carefully planned and assessed to ensure sufficient exposure of the target audience to the health messages.Conclusion Such approaches remain to be empirically tested within the context of dementia risk reduction.Nevertheless,there are consistent models in the evidence base that can be applied with confidence to community education in the current domain.
文摘Water availability in sub-Saharan Africa is increasingly threatened by rapid land use and land cover(LULC)changes,particularly within ecologically sen-sitive areas which are potential areas providing vital hydrological services,and supporting high biodiversity and varieties of ecosystem services.This study as sessed spatial and temporal LULC changes,their underlying drivers,and po-tential community-based interventions in the Kidunda River Catchment,a key upstream area within Tanzania’s Wami-Ruvu Basin where the Kidunda Dam is planned to enhance downstream water supply.Using Landsat imagery from 1994,2005,2016,and 2024,supervised classification with Random Forest al gorithms was applied to detect LULC transitions.Results revealed a significant decline in forest(60.11%)and wetland(68.75%)cover,accompanied by a sub-stantial expansion of cultivated land(226.82%)and built-up areas(196.03%).The most dominant conversion pathways were woodland and wetland to cul-tivated land,indicating intense anthropogenic pressure.Qualitative data from focus group discussions and key informant interviews identified population growth,agricultural expansion,and weak enforcement as key drivers of change.However,a slight slowdown in LULC transformation observed after 2016 co incided with the gazettement of Nyerere National Park,suggesting that policy interventions can yield positive outcomes.Community-driven solutions such as participatory land use planning,agroforestry,and soil and water conservation were highlighted as effective strategies for landscape restoration and water security.The findings underscore the urgent need for integrated catchment man-agement and localized interventions to safeguard the ecological functions of the catchment and ensure the long-term sustainability of the Kidunda Dam and downstream water supplies.
文摘In 2012,an estimated 35.3 million people lived with HIV,while approximately two million new HIV infections were reported.Community-based interventions(CBIs)for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk,or already infected with,HIV.This paper evaluates the impact of CBIs on HIV knowledge,attitudes,and transmission.We included 39 studies on educational activities,counseling sessions,home visits,mentoring,women’s groups,peer leadership,and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence.Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge,attitudes,and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS(SMD:0.66,95%CI:0.25,1.07),protected sexual encounters(RR:1.19,95%CI:1.13,1.25),condom use(SMD:0.96,95%CI:0.03,1.58),and decreased frequency of sexual intercourse(RR:0.76,95%CI:0.61,0.96).Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication.We found very limited evidence on community-based management for HIV infected population and prevention of mother-to-child transmission(MTCT)for HIV-infected pregnant women.Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement.School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group.Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT,and various emerging models of care to improve morbidity and mortality outcomes.
文摘In this paper,we aim to evaluate the effectiveness of community-based interventions(CBIs)for the prevention and management of malaria.We conducted a systematic review and identified 42 studies for inclusion.Twenty-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets(ITNs),indoor residual spraying(IRS),or impregnated bed sheets;14 studies evaluated intermittent preventive therapy(IPT)delivered in community settings;two studies focused on community-based education for malaria prevention;and one study evaluated environmental management through drain cleaning.Our analysis suggests that,overall,the community-based delivery of interventions to prevent and control malaria resulted in a significant increase in ITNs ownership(RR:2.16,95%CI:1.86,2.52)and usage(RR:1.77,95%CI:1.48,2.11).However,usage of ITNs was limited to two-thirds of the population who owned them.Community-based strategies also led to a significant decrease in parasitemia(RR:0.56,95%CI:0.42,0.74),malaria prevalence(RR:0.46,95%CI:0.29,0.73),malaria incidence(RR:0.70,95%CI:0.54,0.90),and anemia prevalence(RR:0.79,95%CI:0.64,0.97).We found a non-significant impact on splenomegaly,birth outcomes(low birth weight,prematurity,stillbirth/miscarriage),anthropometric measures(stunting,wasting,and underweight),and mortality(all-cause and malaria-specific).The subgroup analysis suggested that community-based distribution of ITNs,impregnated bed sheets and IRS,and IPT are effective strategies.Qualitative synthesis suggests that high coverage could be achieved at a lower cost with the integration of CBIs with existing antenatal care and immunization campaigns.Community-based delivery of interventions to prevent and control malaria are effective strategies to improve coverage and access and reduce malaria burden,however,efforts should also be concerted to prevent over diagnosis and drug resistance.
文摘In this paper,we aim to systematically analyze the effectiveness of community-based interventions(CBIs)for the prevention and control of helminthiasis including soil-transmitted helminthiasis(STH)(ascariasis,hookworms,and trichuriasis),lymphatic filariasis,onchocerciasis,dracunculiasis,and schistosomiasis.We systematically reviewed literature published before May 2013 and included 32 studies in this review.Findings from the meta-analysis suggest that CBIs are effective in reducing the prevalence of STH(RR:0.45,95%CI:0.38,0.54),schistosomiasis(RR:0.40,95%CI:0.33,0.50),and STH intensity(SMD:−3.16,95 CI:−4.28,−2.04).They are also effective in improving mean hemoglobin(SMD:0.34,95%CI:0.20,0.47)and reducing anemia prevalence(RR:0.90,95%CI:0.85,0.96).However,it did not have any impact on ferritin,height,weight,low birth weight(LBW),or stillbirths.School-based delivery significantly reduced STH(RR:0.49,95%CI:0.39,0.63)and schistosomiasis prevalence(RR:0.50,95%CI:0.33,0.75),STH intensity(SMD:−0.22,95%CI:−0.26,−0.17),and anemia prevalence(RR:0.87,95%CI:0.81,0.94).It also improved mean hemoglobin(SMD:0.24,95%CI:0.16,0.32).We did not find any conclusive evidence from the quantitative synthesis on the relative effectiveness of integrated and non-integrated delivery strategies due to the limited data available for each subgroup.However,the qualitative synthesis from the included studies supports community-based delivery strategies and suggests that integrated prevention and control measures are more effective in achieving greater coverage compared to the routine vertical delivery,albeit it requires an existing strong healthcare infrastructure.Current evidence suggests that effective community-based strategies exist and deliver a range of preventive,promotive,and therapeutic interventions to combat helminthic neglected tropical diseases(NTDs).However,there is a need to implement and evaluate efficient integrated programs with the existing disease control programs on a larger scale throughout resource-limited regions especially to reach the unreachable.
文摘BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.
文摘Objective:To analyze the effect of interventional nursing on the therapeutic effect,negative emotion and quality of life of patients undergoing cardiovascular and cerebrovascular interventional therapy.Methods:Eighty-four patients who received cardio-cerebral vascular interventional therapy in a hospital during January 2024–December 2024 were selected,and were divided into the control group and the observation group by the mean score method,each with 42 cases.The control group was given standardized perioperative care,and the observation group was given interventional nursing intervention on this basis.The two groups were compared in terms of clinical efficacy,negative emotion score,incidence of related complications,quality of life score and nursing satisfaction.Results:The total effective rate of treatment of patients in the observation group(95.24%)was significantly higher than that of the control group(78.57%),and the difference was statistically significant(P<0.05);before nursing care,the difference between SDS and SAS scores of patients in the two groups was insignificant(P>0.05);after nursing care,the scores of various indexes of the two groups were significantly reduced and the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05);the patients in the observation group had more negative moods than those in the control group;the complication rate of patients in the observation group(2.38%)was significantly lower than that of the control group(19.04%),and the difference was statistically significant(P<0.05);the quality of life scores of patients in the observation group were higher than that of the control group,and the difference was statistically significant(P<0.05);the satisfaction rate of patients’nursing care in the observation group was 97.62%,which was higher than that of the control group(78.57%),and the difference was statistically significant(P<0.05).The difference is statistically significant(P<0.05).Conclusion:The implementation of interventional nursing intervention for patients with cardiovascular and cerebrovascular interventional therapy can further enhance the clinical therapeutic effect,improve the negative emotions of patients’anxiety and depression,reduce the risk of related complications,improve the quality of life of patients,and obtain higher satisfaction.
文摘There have been an increasing number of studies on climate change and population health over the past 20 years,with most focusing on health risk assessment,targeting different locations and populations with various diseases[1−2].While these studies have provided the necessary epidemiological evidence for health authorities in policymaking,it is time to develop and implement tailored health interventions to protect the health and well-being of communities,and particularly that of vulnerable groups.
文摘Psychological interventions have demonstrated efficacy in improving patients’emotional state,cognition,and thinking abilities,thereby enhancing their quality of life and survival.This review examines literature from the China National Knowledge Infrastructure,Wanfang Data,Web of Science,and PubMed databases published over the past decade,focusing on the use of psychotherapy for poststroke anxiety and depression.The prevalence of anxiety and depression is significantly higher among patients who have experienced a stroke than in the general population,possibly due to vestibular dysfunction following brain injury.Current psychological interventions for stroke patients include cognitive behavioral therapy,supportive psychotherapy,music and art therapy,and exercise therapy.These approaches have been shown to promote psychological wellbeing and physical rehabilitation.
基金Yan’an University Students Innovation and Entrepreneurship project funding(202310719006)the National Nature Science Foundation of Chinasupported by the National Nature Science Foundation of China(31160004).
文摘Depression is a common and serious mental disorder,triggered by multiple biological,social and psychological factors.According to the World Health Organization,the incidence of suicide in patients with depression is much higher than in patients with other mental illnesses.Depression has a complex etiology and individual differences,and the effect of single therapy is limited.This review classifies depression into endogenous,exogenous,and secondary categories based on etiology,describes their characteristics,and reviews the research progress of psychological,pharmacological,traditional Chinese medicine,and microbiological interventions.Studies have shown that about 30%-50%of depression has a genetic predisposition;cognitive behavioral therapy is effective for patients with mild-to-moderate depression,and has significant advantages in preventing recurrence,such as networked cognitive behavioral therapy,which is effective in improving mild-to-moderate depressive symptoms,and has a high level of user experience and adherence.Diets rich in dietary fiber,Omega-3 fatty acids,and supplementation with specific probiotics such as Bifidobacterium and Lactobacillus can help alleviate depressive symptoms;preparations of Chinese herbal compounds derived from the Chinese herbal formula,Xiaoyaosan,are effective in alleviating depressive behaviors in mice;and acupuncture is helpful in alleviating primary depression,especially in milder cases.Taken together,gut microbiota influence brain changes through the gut-brain axis.Chinese medicine can realize the combination of Chinese and Western medicine.Both gut microbiota and Chinese medicine show great potential in the treatment of depression.However,the specific therapeutic mechanisms need to be further investigated.
文摘Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.
文摘Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CINAHL,and Web of Science were systematically searched for this network meta-analysis.Randomized controlled studies(RCTs)that included children aged 4-12 years with no physical or mental conditions;performed at least 1 type of lifestyle intervention;reported change in body mass index(BMI),BMI z-score,or body fat percentage(BFP);and were published between January2010 and August 2023 were included.Results:The final analysis included 91 RCTs with aggregate data for 58,649 children.All interventions were categorized into single-arm approaches(physical activity,diet,and behavioral and informational support)and combined arms approaches(bicomponent and multicomponent treatment).Multicomponent treatment showed significant effectiveness on the reduction of BMI(mean deviation(MD)-0.49,95%confidence interval(95%CI):-0.88 to-0.12),BMI z-score(MD=-0.11,95%CI:-0.18 to-0.04),and BFP(MD=-1.69,95%CI:-2.97 to-0.42)compared to the usual care condition.Bicomponent treatment also significantly reduced BMI(MD=-0.28,95%CI:-0.54 to-0.04)and BMI z-score(MD=-0.07,95%CI:-0.12 to-0.02)compared to usual care.Conclusion:Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP.Among single-component approaches,physical activity engagement emerged as the most effective.These findings should guide practitioners in recommending comprehensive lifestyle modifications for children.Moreover,children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.
基金was given by a 2017 Research Grant of the Italian Society of Interventional Cardiology (SICI-GISE)
文摘BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.
文摘Objective: To assess the impact of preoperative psychological interventions on the care of patients undergoing elective surgery. Methods: Ninety-two patients scheduled for elective surgery in the surgical department between August 2021 and August 2023 were selected and divided into groups using a random number table. The observation group received preoperative psychological interventions, while the reference group received standard preoperative care. Anxiety and depression scores, fear grading, vital signs, and self-efficacy levels were compared. Results: After the intervention, the anxiety and depression scores in the observation group were lower than those in the reference group, and the proportion of fear graded as Level I was higher. During the waiting period and 15 minutes before entering the operating room, vital sign levels in the observation group were lower than those in the reference group. Additionally, the self-efficacy scores of the observation group were significantly higher than those of the reference group (P < 0.05). Conclusion: Preoperative psychological interventions can alleviate negative emotions, stabilize preoperative vital signs, and significantly improve self-efficacy in patients undergoing elective surgery, demonstrating high feasibility for implementation.
文摘The initiation and progression of colorectal cancer(CRC)are profoundly influenced by the complex interplay between the gut microbiota and the immune system,underscoring the clinical importance of exploring the bidirectional regulatory mechanisms of the microbiota-immune axis within the CRC immune microenvironment.Emerging evidence indicates that the composition and functional capacity of the gut microbiota play a vital role in modulating the host’s immune responses,while the immune system,in turn,can reciprocally regulate the structure and function of the microbiota.Despite significant insights into the role of the microbiota-immune axis in CRC progression,several critical questions remain unanswered-including how microbial heterogeneity affects therapeutic outcomes and the specific consequences of dysregulated regulatory mechanisms on the immune microenvironment.This review aims to provide a comprehensive analysis of the compositional features of the CRC immune microenvironment,examine the bidirectional molecular mechanisms underpinning the microbiotaimmune axis,and evaluate the potential of targeted therapeutic strategies,thereby offering novel research perspectives and clinical applications for CRC treatment.
基金supported by the Hypatia Fellowship grant from Radboudumc awarded to LB.
文摘Background Exercise during neoadjuvant chemoradiotherapy(NCRT)has potential to mitigate treatment-related declines in physical fitness,and to improve clinical outcomes,including toxicity and tumor response.However,optimal frequency and timing of exercise remains to be determined.Therefore,this pilot trial aimed to assess feasibility of 2 different exercise interventions during NCRT in patients with esophageal and rectal cancer and to evaluate potential clinical effects.Methods Patients were randomized into 1 of 3 study arms during NCRT:(a)30-min aerobic exercise in-hospital within 1 h prior to each radiotherapy fraction(ExPR),(b)two 60-min supervised combined aerobic and resistance exercise sessions per week(AE+RE),and(c)usual care(UC).Feasibility was assessed by examining participation rate and exercise adherence.Intervention effects on physical fitness,health-related quality of life,treatment-related toxicity,and tumor response in patients with esophageal cancer were explored using regression analyses and 85%confidence intervals(85%CIs).Results Thirty-seven patients with esophageal cancer(participation rate=45%)and 2 patients with rectal cancer(participation rate=14%)were included.Median session attendance was 98%(interquartile range(IQR):96%–100%)in the ExPR and 78%(IQR:33%–100%)in the AE+RE group.We found clinically relevant benefits of exercise on maximal oxygen uptake(VO2_(max),mL/kg/min)(ExPR:β=9.7,85%CI:6.9–12.6;AE+RE:β=5.6,85%CI:2.6–8.5)and treatment-related toxicity(ExPR:β=–2.8,85%CI:–5.4 to–0.2;AE+RE:β=–2.6,85%CI:–5.3 to 0.0).Additionally,good tumor response was found in 70%in AE+RE and ExPR vs.55%in UC(odds ratio(OR)=1.9,85%CI:0.5–7.7).Conclusion Starting prehabilitation during NCRT is feasible,can increase starting fitness of traditional pre-surgical programs,and has potential to improve clinical outcomes.
基金Supported by the Teacher Education Research Project of Meizhouwan Vocational and Technical College,No.MZY2407Fujian Province Lifelong Education Quality Enhancement and Excellence Training Project,No.ZS24037.
文摘Cancer significantly impacts patients'physical and mental health,leading to a wide range of effects from physical pain to psychological issues such as anxiety and depression,severely diminishing their quality of life.As an emerging psychosomatic intervention,mindfulness interventions have gained increasing attention.This scoping review systematically searches and filters relevant literature,covering databases from their inception to January 2025,aiming to comprehensively outline the application,research characteristics,and main outcomes of mindfulness interventions in cancer recovery.We employed the Arksey and O'Malley framework,utilizing electronic databases and manual searches to rigorously select studies and extract key data.Results indicate that mindfulness interventions show broad potential in improving cancer patients'mental health,physical symptoms,and quality of life,despite the heterogeneity of the evidence.Future research should focus on higher-quality randomized controlled trials to explore different intervention modalities and long-term effects and to analyze their underlying mechanisms.This paper particularly highlights the advancements in Mindfulness-Based Cancer Recovery,providing valuable references for clinical practice.
基金supported by the Instituto de Salud Carlos III(EstataldeI+D+I2020-2027)co-financed by the European Development Regional Fund“A way to achieve Europe”P2022/BMD-7321(Comunidad de Madrid)and ProACapital,Halekulani S.L.and MJR.
文摘Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disorders is extremely complex,with a wide spectrum of biological,psychological,and sociocultural factors being responsible for their appearance and development.In this sense,immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders,worsening mainly the central nervous system(neuroinflammation)and the periphery of the body(systemic inflammation).However,these alterations cannot be understood separately,but as part of a complex picture in which different factors and systems interact with each other.Psychoneuroimmunoendocrinology(PNIE)is the area responsible for studying the relationship between these elements and the impact of mind–body integration,placing the immune system as part of a whole.Thus,the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche,damage to the nervous system,alterations to the endocrine and metabolic systems,and disruption of the microbiota and intestinal ecosystem,as well as of other organs and,in turn,all these mechanisms are responsible for inducing and enhancing the immune dysfunction.Similarly,the clinical approach to these patients is usually multidisciplinary,and the therapeutic arsenal includes different pharmacological(for example,antidepressants,antipsychotics,and lithium)and non-pharmacological(i.e.,psychotherapy,lifestyle,and electroconvulsive therapy)treatments.These interventions also modulate the immune system and other elements of the PNIE in these patients,which may be interesting to understand the therapeutic success or failure of these approaches.In this sense,this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE.Likewise,an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients,in order to identify the mechanisms described and their possible uses as biomarkers.
文摘Objective:This scoping review explores digital health interventions used to improve maternal health and the health of children under-5-year-olds in rural areas of low-and middle-income countries(LMICs),identifying current practices and research gaps.Methods:Guided by PRISMA Extension for Scoping Reviews,a comprehensive search was conducted across PubMed,Web of Science,and grey literature search with Google Scholar,and the South African National Elec-tronic Theses and Dissertations Portal.MeSH terms and Boolean operators were used.Studies were screened using the Population,Concept,and Context framework,and data were extracted systematically.Results:Of 5,114 records,63 met inclusion criteria.Digital health interventions,particularly mobile health,were found to enhance service delivery,education,and support for maternal and child health in LMICs.However,challenges such as limited access to technology,digital literacy,and cultural barriers persist.Contextual factors,including geography and sociocultural norms,significantly influenced implementation success.Conclusion:Digital health interventions show promise in improving maternal and child health in LMICs.How-ever,regional disparities,technological limitations,and cultural misalignment hinder scalability.Future research should focus on culturally adaptive,community-engaged approaches and long-term impact assessments to sup-port sustainable health promotion in low-resource settings.
文摘Objective:To assess the method of empathy intervention in nursing students in relation to the three dimensions of empathy:cognitive,affective,and behavioral.Methods:A systematic literature review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guideline.A search for articles in two databases(ScienceDirect and Taylor&Francis)revealed 99 articles.One author independently assessed articles for inclusion,resulting in 10 articles that met the inclusion criteria.Results:Based on a review of ten extracted journal articles,nine interventions showed increases in empathy,while one intervention did not show such outcomes.Four studies(the simulation-based empathic communication training intervention,the situated teaching program,high-fidelity simulation[HFS]training,and the structured empathy educational model[EEM])discussed the impact of interventions on the empathy dimension,while the remaining five only explained the impact of the intervention on empathy in general.Conclusions:The result of this study highlight the need for future research to design empathy interventions for nursing students that effectively target both the affective and behavioral dimensions of empathy.
