Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CH...Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.展开更多
Objective To reduce health-related threats of heat waves, interventions have been implemented in many parts of the world. However, there is a lack of higher-level evidence concerning the intervention efficacy. This st...Objective To reduce health-related threats of heat waves, interventions have been implemented in many parts of the world. However, there is a lack of higher-level evidence concerning the intervention efficacy. This study aimed to determine the efficacy of an intervention to reduce the number of heat-related illnesses. Methods A quasi-experimental design was employed by two cross-sectional surveys in the year 2024 and 2015, including 2,240 participants and 2,356 participants, respectively. Each survey was designed to include one control group and one intervention group, which conducted in Licheng, China. A representative sample was selected using a multistage sampling method. Data, collected from questionnaires about heat waves in 2014 and 2015, were analyzed using a difference-in-difference analysis and cost effectiveness analysis. Outcomes included changes in the prevalence of heat-related illnesses and cost-effectiveness variables. Results Relative to the control participants, the prevalence of heat-related illness in the intervention participants decreased to a greater extent in rural areas than in urban areas （OR=0.495 vs. OR=2.282）. Moreover, the cost-effectiveness ratio in the intervention group was tess than that in the control group （usS25.06 vs. us$25.69 per participant）. Furthermore, to avoid one additional patient, the incremental cost-effectiveness ratio showed that an additional USS14.47 would be needed for the intervention compared to when no intervention was applied. Conclusion The intervention program may be considered a worthwhile investment for rural areas that are more likely to experience heat waves. Meanwhile, corresponding improving measures should be presented towards urban areas. Future research should examine whether the intervention strategies could be spread out in other domestic or international regions where heat waves are usually experienced.展开更多
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
Aim： To evaluate the effectiveness of a community-based intervention program for NCD （non-communicable disease） risk factors prevention. Materials and methods： The authors conducted a quasi experimental study with...Aim： To evaluate the effectiveness of a community-based intervention program for NCD （non-communicable disease） risk factors prevention. Materials and methods： The authors conducted a quasi experimental study with a control group over five years between 2009 and 2014 in the region of Sousse, Tunisia. In each group, the sample size required was 1,000 participants. For this, the authors randomly selected 500 households from two areas and they included all adults aged 18 years and older in these households. They evaluated the habits of participants from both intervention and control groups at baseline in 2009-2010 and after three years of intervention in 2013-2014. They focused on the main lifestyle risk factors represented by poor diet, physical inactivity, and tobacco use. Results： Tobacco use decreased significantly among men by 7.3% （/9 = 0.03） in the intervention group, versus an increase of 3.5% in the control group （p = 0.4）. Physical activity and fruits and vegetables intake increased significantly respectively by 25% （p 〈 0.001） and 19% （p 〈 0.001） in intervention group. Conclusion： The results suggest that a combined community-based lifestyle intervention in a developing country, can significantly improve some NCD risk factors. However, a supportive environment or a gender approach is required to maximize the effectiveness and maintain the sustainability of the health intervention.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:Several studies highlighted the impact of community-based interventions whose purpose was to reduce the vectors’breeding sites.These strategies are particularly interesting in low-and-middle-income countri...Background:Several studies highlighted the impact of community-based interventions whose purpose was to reduce the vectors’breeding sites.These strategies are particularly interesting in low-and-middle-income countries which may find it difficult to sustainably assume the cost of insecticide-based interventions.In this case study we determine the spatial distribution of a community-based intervention for dengue vector control using different entomological indices.The objective was to evaluate locally where the intervention was most effective,using spatial analysis methods that are too often neglected in impact assessments.Methods:Two neighbourhoods,Tampouy and Juvenat in Ouagadougou,Burkina Faso,were chosen among five after a survey was conducted,as part of an assessment related to the burden of dengue.As part of the communitybased intervention conducted in Tampouy between August and early October 2016,an entomological survey was implemented in two phases.The first phase consisted of a baseline entomological characterization of potential breeding sites in the neighbourhood of Tampouy as well as in Juvenat,the control area.This phase was conducted in October 2015 at the end of the rainy season.The mosquito breeding sites were screened in randomly selected houses:206 in Tampouy and 203 in Juvenat.A second phase took place after the intervention,in October 2016.The mosquito breeding sites were investigated in the same yards as during the baseline phase.We performed several entomological analyses to measure site productivity as well as before and after analysis using multilevel linear regression.We used Local Indicators of Spatial Association(LISAs)to analyse spatial concentrations of larvae.Results:After the intervention,it is noted that LISAs at Tampouy reveal few aggregates of all types and the suppression of those existing before the intervention.The analysis therefore reveals that the intervention made it possible to reduce the number of concentration areas of high and low values of pupae.Conclusions:The contribution of spatial methods for assessing community-based intervention are relevant for monitoring at local levels as a complement to epidemiological analyses conducted within neighbourhoods.They are useful,therefore,not only for assessment but also for establishing interventions.This study shows that spatial analyses also have their place in population health intervention research.展开更多
Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.T...Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.展开更多
This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensive...This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensively evaluated the research progress.The research indicates a shift from basic supportive care toward precision intervention strategies.Immunonutrition approaches,such as omega-3 fatty acid supplementation and probiotics for gut microbiota modulation,significantly mitigate chemotherapy-related side effects and enhance nutritional status.These targeted novel regimens demonstrate clear clinical advantages.The success of nutritional management depends on a multidisciplinary collaboration mechanism.The organic integration of innovative nutritional protocols with standard treatments from hematology,pediatrics,and nutrition departments significantly optimizes treatment outcomes and long-term quality of life for children with leukemia.This interdisciplinary synergy is reshaping contemporary medical models.展开更多
Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interv...Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.展开更多
Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic s...Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic stroke admitted to our hospital from June 2024 to June 2025 were selected and divided into two groups using the red and blue ball method:the control group(n=30,receiving routine interventional room nursing)and the observation group(n=31,receiving additional tirofiban medication-specific nursing+individualized interventional nursing on the basis of routine nursing).The cerebral hemodynamic indicators,adverse reactions,effectiveness of complication nursing,and nursing satisfaction were compared between the two groups.Results:After 7 days of treatment,the observation group had lower cerebrovascular peripheral resistance and higher mean blood flow velocity and mean blood flow volume compared to the control group(all p<0.05).The observation group had a higher effectiveness rate of complication nursing than the control group,with a statistically significant difference(p<0.05).The nursing satisfaction in the observation group(96.77%)was higher than that in the control group(80.00%),with a statistically significant difference(χ^(2)=4.223,p=0.040<0.05).Conclusion:Tirofiban combined with direct thrombectomy can significantly improve cerebral hemodynamics,enhance the effectiveness of complication nursing,and increase patient satisfaction in patients with ischemic stroke.展开更多
Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By...Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By reviewing relevant domestic and foreign studies and clinical practices,this paper summarizes and analyzes the main application forms of digital health interventions,including digital health education,intelligent detection equipment,telemedicine platforms,oral health big data platforms,and school-hospital collaborative screening robots.Results:Studies have shown that digital health interventions can effectively improve the public’s oral health knowledge level,optimize personal health behaviors,enhance clinical diagnosis efficiency,reduce overall medical costs,and promote the innovation and upgrading of oral health management models.Conclusion:Digital health intervention represents an inevitable trend in the future development of stomatology.In the future,it is still necessary to improve data security and privacy protection,technology adaptability and popularity,as well as relevant policies and norms,to give full play to its potential value.展开更多
Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains ...Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communication,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.展开更多
Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strate...Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.展开更多
BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emoti...BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.展开更多
Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neu...Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.展开更多
Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the...Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.展开更多
The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 ...The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.展开更多
基金supported by the University of Jember for funding IDB grand research No.2589/UN25.3.1/LT/2020。
文摘Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.
基金supported by National Basic Research Program of China(973 Program)(Grant No.2012CB955504)
文摘Objective To reduce health-related threats of heat waves, interventions have been implemented in many parts of the world. However, there is a lack of higher-level evidence concerning the intervention efficacy. This study aimed to determine the efficacy of an intervention to reduce the number of heat-related illnesses. Methods A quasi-experimental design was employed by two cross-sectional surveys in the year 2024 and 2015, including 2,240 participants and 2,356 participants, respectively. Each survey was designed to include one control group and one intervention group, which conducted in Licheng, China. A representative sample was selected using a multistage sampling method. Data, collected from questionnaires about heat waves in 2014 and 2015, were analyzed using a difference-in-difference analysis and cost effectiveness analysis. Outcomes included changes in the prevalence of heat-related illnesses and cost-effectiveness variables. Results Relative to the control participants, the prevalence of heat-related illness in the intervention participants decreased to a greater extent in rural areas than in urban areas （OR=0.495 vs. OR=2.282）. Moreover, the cost-effectiveness ratio in the intervention group was tess than that in the control group （usS25.06 vs. us$25.69 per participant）. Furthermore, to avoid one additional patient, the incremental cost-effectiveness ratio showed that an additional USS14.47 would be needed for the intervention compared to when no intervention was applied. Conclusion The intervention program may be considered a worthwhile investment for rural areas that are more likely to experience heat waves. Meanwhile, corresponding improving measures should be presented towards urban areas. Future research should examine whether the intervention strategies could be spread out in other domestic or international regions where heat waves are usually experienced.
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Aim： To evaluate the effectiveness of a community-based intervention program for NCD （non-communicable disease） risk factors prevention. Materials and methods： The authors conducted a quasi experimental study with a control group over five years between 2009 and 2014 in the region of Sousse, Tunisia. In each group, the sample size required was 1,000 participants. For this, the authors randomly selected 500 households from two areas and they included all adults aged 18 years and older in these households. They evaluated the habits of participants from both intervention and control groups at baseline in 2009-2010 and after three years of intervention in 2013-2014. They focused on the main lifestyle risk factors represented by poor diet, physical inactivity, and tobacco use. Results： Tobacco use decreased significantly among men by 7.3% （/9 = 0.03） in the intervention group, versus an increase of 3.5% in the control group （p = 0.4）. Physical activity and fruits and vegetables intake increased significantly respectively by 25% （p 〈 0.001） and 19% （p 〈 0.001） in intervention group. Conclusion： The results suggest that a combined community-based lifestyle intervention in a developing country, can significantly improve some NCD risk factors. However, a supportive environment or a gender approach is required to maximize the effectiveness and maintain the sustainability of the health intervention.
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.
基金This work was supported by the Canadian Institutes of Health Research,which funded the program(grant no.ROH-115213)S.O.received a postdoctoral fellowship from the Fonds des Recherches du Québec en Santé.V.R.holds a Canadian Institutes of Health Research–funded Research Chair in Applied Public Health(grant no.CPP-137901).
文摘Background:Several studies highlighted the impact of community-based interventions whose purpose was to reduce the vectors’breeding sites.These strategies are particularly interesting in low-and-middle-income countries which may find it difficult to sustainably assume the cost of insecticide-based interventions.In this case study we determine the spatial distribution of a community-based intervention for dengue vector control using different entomological indices.The objective was to evaluate locally where the intervention was most effective,using spatial analysis methods that are too often neglected in impact assessments.Methods:Two neighbourhoods,Tampouy and Juvenat in Ouagadougou,Burkina Faso,were chosen among five after a survey was conducted,as part of an assessment related to the burden of dengue.As part of the communitybased intervention conducted in Tampouy between August and early October 2016,an entomological survey was implemented in two phases.The first phase consisted of a baseline entomological characterization of potential breeding sites in the neighbourhood of Tampouy as well as in Juvenat,the control area.This phase was conducted in October 2015 at the end of the rainy season.The mosquito breeding sites were screened in randomly selected houses:206 in Tampouy and 203 in Juvenat.A second phase took place after the intervention,in October 2016.The mosquito breeding sites were investigated in the same yards as during the baseline phase.We performed several entomological analyses to measure site productivity as well as before and after analysis using multilevel linear regression.We used Local Indicators of Spatial Association(LISAs)to analyse spatial concentrations of larvae.Results:After the intervention,it is noted that LISAs at Tampouy reveal few aggregates of all types and the suppression of those existing before the intervention.The analysis therefore reveals that the intervention made it possible to reduce the number of concentration areas of high and low values of pupae.Conclusions:The contribution of spatial methods for assessing community-based intervention are relevant for monitoring at local levels as a complement to epidemiological analyses conducted within neighbourhoods.They are useful,therefore,not only for assessment but also for establishing interventions.This study shows that spatial analyses also have their place in population health intervention research.
文摘Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.
文摘This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensively evaluated the research progress.The research indicates a shift from basic supportive care toward precision intervention strategies.Immunonutrition approaches,such as omega-3 fatty acid supplementation and probiotics for gut microbiota modulation,significantly mitigate chemotherapy-related side effects and enhance nutritional status.These targeted novel regimens demonstrate clear clinical advantages.The success of nutritional management depends on a multidisciplinary collaboration mechanism.The organic integration of innovative nutritional protocols with standard treatments from hematology,pediatrics,and nutrition departments significantly optimizes treatment outcomes and long-term quality of life for children with leukemia.This interdisciplinary synergy is reshaping contemporary medical models.
文摘Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.
文摘Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic stroke admitted to our hospital from June 2024 to June 2025 were selected and divided into two groups using the red and blue ball method:the control group(n=30,receiving routine interventional room nursing)and the observation group(n=31,receiving additional tirofiban medication-specific nursing+individualized interventional nursing on the basis of routine nursing).The cerebral hemodynamic indicators,adverse reactions,effectiveness of complication nursing,and nursing satisfaction were compared between the two groups.Results:After 7 days of treatment,the observation group had lower cerebrovascular peripheral resistance and higher mean blood flow velocity and mean blood flow volume compared to the control group(all p<0.05).The observation group had a higher effectiveness rate of complication nursing than the control group,with a statistically significant difference(p<0.05).The nursing satisfaction in the observation group(96.77%)was higher than that in the control group(80.00%),with a statistically significant difference(χ^(2)=4.223,p=0.040<0.05).Conclusion:Tirofiban combined with direct thrombectomy can significantly improve cerebral hemodynamics,enhance the effectiveness of complication nursing,and increase patient satisfaction in patients with ischemic stroke.
文摘Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By reviewing relevant domestic and foreign studies and clinical practices,this paper summarizes and analyzes the main application forms of digital health interventions,including digital health education,intelligent detection equipment,telemedicine platforms,oral health big data platforms,and school-hospital collaborative screening robots.Results:Studies have shown that digital health interventions can effectively improve the public’s oral health knowledge level,optimize personal health behaviors,enhance clinical diagnosis efficiency,reduce overall medical costs,and promote the innovation and upgrading of oral health management models.Conclusion:Digital health intervention represents an inevitable trend in the future development of stomatology.In the future,it is still necessary to improve data security and privacy protection,technology adaptability and popularity,as well as relevant policies and norms,to give full play to its potential value.
文摘Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communication,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.
文摘Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.
文摘BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.
基金Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),project numbers 324633948 and 409784463(DFG grants Hi 678/9-3 and Hi 678/10-2,FOR2953)to HHBundesministerium für Bildung und Forschung-BMBF,project number 16LW0463K to HT.
文摘Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.
文摘Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.
文摘The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.
