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
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
BACKGROUND Chylous ascites(CA),which is characterized by lymphatic leakage into the peritoneal cavity,is a rare but significant complication of liver transplantation.Although dietary and pharmacological strategies hav...BACKGROUND Chylous ascites(CA),which is characterized by lymphatic leakage into the peritoneal cavity,is a rare but significant complication of liver transplantation.Although dietary and pharmacological strategies have shown effectiveness in managing CA,standardized treatment protocols have yet to be established.AIMTo evaluate the comparative effectiveness of low-fat diet (LFD) enriched with medium-chain triglycerides (MCTs)vs octreotide therapy in managing post-liver transplantation CA.METHODSA comprehensive literature review was conducted to analyze the outcomes of dietary interventions and octreotidetherapy. The key parameters examined included resolution rates, treatment duration, and recurrence.RESULTSA comprehensive literature search yielded 13 studies that met the inclusion criteria, comprising 4 retrospectivecohort studies and 8 case studies. The incidence of CA following liver transplantation ranges from 0.6% to 4.7%.The onset varied, with a median time to diagnosis of 10 days after transplantation. A LFD with MCT supplementationwas used as the first-line therapy in 83.3% of the studies, with resolution rates ranging from 62.5% to100%. Octreotide therapy was utilized in 66.7% of the studies, primarily as a second-line therapy, with resolutionrates of 83.3% to 100%. Combination therapy showed a significantly higher resolution rate than did dietarymanagement alone (97.8% vs 78.9%, P = 0.02). The time to resolution was significantly shorter with octreotidecontainingregimens than with dietary management alone (median, 7 days vs 14 days;P = 0.03).CONCLUSIONA stepwise approach to CA management is recommended, initiating dietary interventions and escalating tooctreotide when necessary. Further research through well-designed randomized controlled trials is essential toestablish standardized treatment protocols for optimizing patient outcomes.展开更多
To the Editor:As a student actively involved in advocacy for heart disease prevention,I was particularly intrigued by the policymaking implications of digital interventions in the article "Digital components and ...To the Editor:As a student actively involved in advocacy for heart disease prevention,I was particularly intrigued by the policymaking implications of digital interventions in the article "Digital components and interaction types in counseling interventions for childhood and adolescent obesity:A systematic review" [1].Through my work as the Founder and President of the nonprofit Guardians of Heart,I have developed and promoted early educational programs,digital tools,and community outreach initiatives designed to instill heart-healthy habits in youth,intending to mitigate risk factors such as obesity that significantly contribute to cardiovascular disease later in life.展开更多
Tuberculous meningitis(TBM),which accounts for 1%-5%of global tuberculosis cases,is a severe neurological infection with a mortality rate of 30%-50%.Its high fatality and disability rates disproportionately affect low...Tuberculous meningitis(TBM),which accounts for 1%-5%of global tuberculosis cases,is a severe neurological infection with a mortality rate of 30%-50%.Its high fatality and disability rates disproportionately affect low-and middle-income regions(e.g.,sub-Saharan Africa and Southeast Asia),threatening the lives of patients and imposing significant psychosocial burdens.Recent studies have highlighted the crucial role of psychosocial factors,including socioeconomic status,disease severity,and social support systems in recovery.However,research gaps persist in developing TBM-specific psychosocial interventions.This narrative review summarizes and organizes the key findings of observational studies,cohort studies,and intervention trials published between 2015 and 2024.Databases including PubMed,Scopus,and Web of Science were searched for terms related to TBM,psychosocial risk factors and mental health interventions.Studies were screened for relevance and quality,focusing on those that examined the psychological and social determinants of mental health outcomes in patients with TBM.展开更多
Orthodontic osteodilated arch treatment represents a pivotal approach in dental orthodontics to address dental crowding and misalignment.Integrating cognitive behavioral therapy(CBT)into comprehensive nursing interven...Orthodontic osteodilated arch treatment represents a pivotal approach in dental orthodontics to address dental crowding and misalignment.Integrating cognitive behavioral therapy(CBT)into comprehensive nursing interventions(CNI)aims to address these issues holistically.This editorial explores the effectiveness of CBTbased CNI in improving patient outcomes in orthodontic care.Innovations in remote CBT delivery,such as virtual reality,have also shown potential in reducing pain,anxiety,and depression,emphasizing CBT's adaptability in orthodontic settings.The findings underscore the importance of integrating psychological support into orthodontic care to enhance patient adherence,satisfaction,and overall treatment success.The editorial advocates for a holistic approach that combines psychological and physiological care,highlighting the transformative potential of CBT-based interventions in orthodontic treatment.展开更多
This review aims to gain a deeper understanding of the current interventions used in high-income and low-and middle-income countries worldwide on treatment engagement among persons with severe mental illnesses.Treatme...This review aims to gain a deeper understanding of the current interventions used in high-income and low-and middle-income countries worldwide on treatment engagement among persons with severe mental illnesses.Treatment engagement involves cultivating therapeutic partnerships to address patients’unique needs and challenges.This multifaceted process requires sensitivity,collaboration,and a tailored approach to promote positive outcomes.Effective treatment engagement reduces the chances of relapse and rehospitalization and helps individuals steer through their daily lives and social relationships.Through literature analysis,it was found that individual,situational,and environmental factors affected treatment engagement.Community nurses are crucial in promoting behavioral changes by engaging patients and applying tailor-made interventions.Applying problem-solving,coping skills,and strategies to address factors influencing adherence,motivational interviewing,and telephone follow-ups yielded significant results.The interventions recommended in community settings are tele-aftercare programs and home visits to address issues of dropped-out persons with severe mental illnesses and ensure continuity of treatment.Accessible,nonstigmatizing,non-coercive,informal,and appropriate services are suggested.These interventions can improve treatment engagement,medication adherence,and therapeutic alliance,thereby reducing symptoms and improving patients’quality of life.展开更多
Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involve...Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involves complex mechanisms,including altered coagulation,cardiovascular function,and pain perception.Common psychiatric disorders in surgical patients,such as anxiety,depression,and substance use disorders,vary in prevalence and manifestation.Demographic factors,comorbidities,and psychotropic medications further modulate these effects on surgical outcomes.Effective screening and assessment strategies are crucial,yet they present both opportunities and limitations in the preoperative setting.Preoperative psychological interventions,including cognitive-behavioral therapy,supportive care,and mind-body techniques,show promise in mitigating psychological distress and improving surgical outcomes.Multidisciplinary approaches,involving collaborative efforts between psychiatric and surgical teams,are essential to provide comprehensive patient care.Emerging inter-ventions,technological innovations,and personalized medicine approaches offer exciting possibilities to advance preoperative psychiatric care.By understanding the complex interplay between psychiatric disorders and surgical outcomes,healthcare professionals can implement integrated,patient-centered approaches to optimize perioperative care and improve overall patient outcomes.展开更多
BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of post...BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of postoperative nursing interventions,particularly pain management,is crucial for reducing such complications.AIM To investigate the effects of enhanced recovery nursing on CV complications after gastrointestinal surgery in ICU patients and associated risk factors.METHODS A retrospective analysis was conducted on 78 adult patients who underwent gastrointestinal surgery in the ICU of our hospital between February 2023 and September 2024.Among them,40 patients received standard care(control group),while 38 received enhanced recovery nursing(observation group).We compared the incidence of CV complications and nursing satisfaction between the two groups.Patients were divided into CV complication and non-complication groups based on complication occurrence,and logistic regression analysis was used to identify risk factors.RESULTS In the control and observation groups,the incidence of CV complications was 30.0%(12/40)and 18.4%(7/38),with a nursing satisfaction rate of 70.0%(28/40)and 92.1%(35/38),respectively.The postoperative pain score at 14 days was significantly lower in the observation group(0.27±0.15)compared to the control group(1.65±0.37),with all differences being statistically significant(P<0.05).Univariate analysis indicated significant differences in age,body mass index,hypertension,diabetes,smoking history,history of heart failure,and previous myocardial infarction(P<0.05).Multivariate logistic regression identified heart failure history,previous myocardial infarction,age,hypertension,and diabetes as independent risk factors,with odds ratios of 1.195,1.528,1.062,1.836,and 1.942,respectively(all P<0.05).CONCLUSION Implementing enhanced recovery nursing for ICU patients after gastrointestinal surgery is beneficial in reducing the incidence of CV complications and improving nursing satisfaction.展开更多
Teenage pregnancy has been acknowledged as a global public health concern,especially in low-and middle-income nations[1].This is predominantly because teenagers are more likely to experience pregnancy complications(vi...Teenage pregnancy has been acknowledged as a global public health concern,especially in low-and middle-income nations[1].This is predominantly because teenagers are more likely to experience pregnancy complications(viz.anemia,obstructed labour,etc.),higher rates of maternal mortality,and neonatal complications,including mortality[1,2].It is not unusual that many teen mothers have to experience exclusion from their families and communities,which limits access to quality healthcare services and is a major reason for emotional stress and mental health problems[2].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
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integ...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integrated personalized diet,exercise,and cognitive behavior therapy,delivered via MyTatva’s digital health application enabled through a body composition analyzer(BCA)and smartwatch.AIM To evaluates the effectiveness of the comprehensive program delivered via My-Tatva’s digital health app enabled through internet of thing devices.METHODS This retrospective observational study analyzed deidentified data from 22 par-ticipants enrolled in the MyTatva RESET care program.Participants were divided into three groups:Group A,diet plan;Group B,diet+exercise plan;and Group C,diet+exercise+cognitive behavioral therapy plan.Participants were provided with a BCA and smartwatch for continuous monitoring of anthropometric para-meters.Statistical analysis,including one-way ANOVA and post-hoc Tukey’s Honest Significant Difference test,was conducted to compare mean changes in anthropometric parameters across the groups.INTRODUCTION Non-alcoholic fatty liver disease(NAFLD)has emerged as a global health burden,affecting approximately 1 in 4 in-dividuals worldwide.NAFLD ranges from simple steatosis(fat accumulation)to non-alcoholic steatohepatitis(NASH),and its global prevalence in the general population is estimated between 6.3%and 33%,with NASH affecting 3-5%[1,2].Obesity is a major risk factor of NAFLD,with studies showing that the likelihood of developing NAFLD increases 5-fold at a body mass index(BMI)of 30-32.5 kg/m²and up to 14-fold at BMI of 37.5-40 kg/m²compared to a BMI of 20-22.5 kg/m²[3,4].Effective NAFLD management requires both dietary and physical activity modifications.Healthy weight loss with sustained muscle mass plays a pivotal role,with a reduction of 3%-5%decreasing hepatic steatosis,5%-7%improving NASH conditions,and 10%or more needed to reverse hepatic fibrosis[5].Management also normalizes elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase),enhances insulin sensitivity,and thereby reduces cardiovascular risk by improving endothelial function and increasing cardiorespiratory fitness[6].However,diet or exercise alone is often not as effective as a combined approach.Integrating both balanced dietary changes and increased physical activity yields more sustainable improvements in NAFLD and overall metabolic health[1,7].Traditional intervention methods usually involve in-person consultations,which often lack real-time and continuous patient monitoring.The recommendation of drastic changes in diet and exercise can also be overwhelming for patients,leading to low adherence rates.Many patients struggle to maintain these changes in the long-term due to a lack of con-tinuous motivational support[8,9].In recent years,the health ecosystem has witnessed a significant shift toward digital health platforms,which complement pharmacological treatments in chronic disease management,and increase scala-bility.These platforms provide continuous monitoring and personalized support,helping to bridge the gap between health care setups and patients[10].Recent digital advances enable internet of things(IoT)devices to be integrated into such management plans to track health metrics,to address the limitations of traditional methods[11,12].The MyTatva digital health application offers the RESET plan,a novel comprehensive approach for NAFLD mana-gement by integrating personalized support from nutrition,physiotherapy,and cognitive behavioral therapy(CBT)coaches.We aimed to evaluate the effectiveness of the RESET plan by analyzing the reduction in anthropometric para-meters across three different digital intervention groups.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
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
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
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
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
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
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
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.
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BACKGROUND Chylous ascites(CA),which is characterized by lymphatic leakage into the peritoneal cavity,is a rare but significant complication of liver transplantation.Although dietary and pharmacological strategies have shown effectiveness in managing CA,standardized treatment protocols have yet to be established.AIMTo evaluate the comparative effectiveness of low-fat diet (LFD) enriched with medium-chain triglycerides (MCTs)vs octreotide therapy in managing post-liver transplantation CA.METHODSA comprehensive literature review was conducted to analyze the outcomes of dietary interventions and octreotidetherapy. The key parameters examined included resolution rates, treatment duration, and recurrence.RESULTSA comprehensive literature search yielded 13 studies that met the inclusion criteria, comprising 4 retrospectivecohort studies and 8 case studies. The incidence of CA following liver transplantation ranges from 0.6% to 4.7%.The onset varied, with a median time to diagnosis of 10 days after transplantation. A LFD with MCT supplementationwas used as the first-line therapy in 83.3% of the studies, with resolution rates ranging from 62.5% to100%. Octreotide therapy was utilized in 66.7% of the studies, primarily as a second-line therapy, with resolutionrates of 83.3% to 100%. Combination therapy showed a significantly higher resolution rate than did dietarymanagement alone (97.8% vs 78.9%, P = 0.02). The time to resolution was significantly shorter with octreotidecontainingregimens than with dietary management alone (median, 7 days vs 14 days;P = 0.03).CONCLUSIONA stepwise approach to CA management is recommended, initiating dietary interventions and escalating tooctreotide when necessary. Further research through well-designed randomized controlled trials is essential toestablish standardized treatment protocols for optimizing patient outcomes.
文摘To the Editor:As a student actively involved in advocacy for heart disease prevention,I was particularly intrigued by the policymaking implications of digital interventions in the article "Digital components and interaction types in counseling interventions for childhood and adolescent obesity:A systematic review" [1].Through my work as the Founder and President of the nonprofit Guardians of Heart,I have developed and promoted early educational programs,digital tools,and community outreach initiatives designed to instill heart-healthy habits in youth,intending to mitigate risk factors such as obesity that significantly contribute to cardiovascular disease later in life.
文摘Tuberculous meningitis(TBM),which accounts for 1%-5%of global tuberculosis cases,is a severe neurological infection with a mortality rate of 30%-50%.Its high fatality and disability rates disproportionately affect low-and middle-income regions(e.g.,sub-Saharan Africa and Southeast Asia),threatening the lives of patients and imposing significant psychosocial burdens.Recent studies have highlighted the crucial role of psychosocial factors,including socioeconomic status,disease severity,and social support systems in recovery.However,research gaps persist in developing TBM-specific psychosocial interventions.This narrative review summarizes and organizes the key findings of observational studies,cohort studies,and intervention trials published between 2015 and 2024.Databases including PubMed,Scopus,and Web of Science were searched for terms related to TBM,psychosocial risk factors and mental health interventions.Studies were screened for relevance and quality,focusing on those that examined the psychological and social determinants of mental health outcomes in patients with TBM.
基金Basic Science Research Program Through the National Research Foundation of Korea Funded by the Ministry of Education,No.NRF-RS-2023-00237287 and No.NRF-2021S1A5A8062526Local Government-University Cooperation-Based Regional Innovation Projects,No.2021RIS-003.
文摘Orthodontic osteodilated arch treatment represents a pivotal approach in dental orthodontics to address dental crowding and misalignment.Integrating cognitive behavioral therapy(CBT)into comprehensive nursing interventions(CNI)aims to address these issues holistically.This editorial explores the effectiveness of CBTbased CNI in improving patient outcomes in orthodontic care.Innovations in remote CBT delivery,such as virtual reality,have also shown potential in reducing pain,anxiety,and depression,emphasizing CBT's adaptability in orthodontic settings.The findings underscore the importance of integrating psychological support into orthodontic care to enhance patient adherence,satisfaction,and overall treatment success.The editorial advocates for a holistic approach that combines psychological and physiological care,highlighting the transformative potential of CBT-based interventions in orthodontic treatment.
文摘This review aims to gain a deeper understanding of the current interventions used in high-income and low-and middle-income countries worldwide on treatment engagement among persons with severe mental illnesses.Treatment engagement involves cultivating therapeutic partnerships to address patients’unique needs and challenges.This multifaceted process requires sensitivity,collaboration,and a tailored approach to promote positive outcomes.Effective treatment engagement reduces the chances of relapse and rehospitalization and helps individuals steer through their daily lives and social relationships.Through literature analysis,it was found that individual,situational,and environmental factors affected treatment engagement.Community nurses are crucial in promoting behavioral changes by engaging patients and applying tailor-made interventions.Applying problem-solving,coping skills,and strategies to address factors influencing adherence,motivational interviewing,and telephone follow-ups yielded significant results.The interventions recommended in community settings are tele-aftercare programs and home visits to address issues of dropped-out persons with severe mental illnesses and ensure continuity of treatment.Accessible,nonstigmatizing,non-coercive,informal,and appropriate services are suggested.These interventions can improve treatment engagement,medication adherence,and therapeutic alliance,thereby reducing symptoms and improving patients’quality of life.
文摘Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involves complex mechanisms,including altered coagulation,cardiovascular function,and pain perception.Common psychiatric disorders in surgical patients,such as anxiety,depression,and substance use disorders,vary in prevalence and manifestation.Demographic factors,comorbidities,and psychotropic medications further modulate these effects on surgical outcomes.Effective screening and assessment strategies are crucial,yet they present both opportunities and limitations in the preoperative setting.Preoperative psychological interventions,including cognitive-behavioral therapy,supportive care,and mind-body techniques,show promise in mitigating psychological distress and improving surgical outcomes.Multidisciplinary approaches,involving collaborative efforts between psychiatric and surgical teams,are essential to provide comprehensive patient care.Emerging inter-ventions,technological innovations,and personalized medicine approaches offer exciting possibilities to advance preoperative psychiatric care.By understanding the complex interplay between psychiatric disorders and surgical outcomes,healthcare professionals can implement integrated,patient-centered approaches to optimize perioperative care and improve overall patient outcomes.
文摘BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of postoperative nursing interventions,particularly pain management,is crucial for reducing such complications.AIM To investigate the effects of enhanced recovery nursing on CV complications after gastrointestinal surgery in ICU patients and associated risk factors.METHODS A retrospective analysis was conducted on 78 adult patients who underwent gastrointestinal surgery in the ICU of our hospital between February 2023 and September 2024.Among them,40 patients received standard care(control group),while 38 received enhanced recovery nursing(observation group).We compared the incidence of CV complications and nursing satisfaction between the two groups.Patients were divided into CV complication and non-complication groups based on complication occurrence,and logistic regression analysis was used to identify risk factors.RESULTS In the control and observation groups,the incidence of CV complications was 30.0%(12/40)and 18.4%(7/38),with a nursing satisfaction rate of 70.0%(28/40)and 92.1%(35/38),respectively.The postoperative pain score at 14 days was significantly lower in the observation group(0.27±0.15)compared to the control group(1.65±0.37),with all differences being statistically significant(P<0.05).Univariate analysis indicated significant differences in age,body mass index,hypertension,diabetes,smoking history,history of heart failure,and previous myocardial infarction(P<0.05).Multivariate logistic regression identified heart failure history,previous myocardial infarction,age,hypertension,and diabetes as independent risk factors,with odds ratios of 1.195,1.528,1.062,1.836,and 1.942,respectively(all P<0.05).CONCLUSION Implementing enhanced recovery nursing for ICU patients after gastrointestinal surgery is beneficial in reducing the incidence of CV complications and improving nursing satisfaction.
文摘Teenage pregnancy has been acknowledged as a global public health concern,especially in low-and middle-income nations[1].This is predominantly because teenagers are more likely to experience pregnancy complications(viz.anemia,obstructed labour,etc.),higher rates of maternal mortality,and neonatal complications,including mortality[1,2].It is not unusual that many teen mothers have to experience exclusion from their families and communities,which limits access to quality healthcare services and is a major reason for emotional stress and mental health problems[2].
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BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integrated personalized diet,exercise,and cognitive behavior therapy,delivered via MyTatva’s digital health application enabled through a body composition analyzer(BCA)and smartwatch.AIM To evaluates the effectiveness of the comprehensive program delivered via My-Tatva’s digital health app enabled through internet of thing devices.METHODS This retrospective observational study analyzed deidentified data from 22 par-ticipants enrolled in the MyTatva RESET care program.Participants were divided into three groups:Group A,diet plan;Group B,diet+exercise plan;and Group C,diet+exercise+cognitive behavioral therapy plan.Participants were provided with a BCA and smartwatch for continuous monitoring of anthropometric para-meters.Statistical analysis,including one-way ANOVA and post-hoc Tukey’s Honest Significant Difference test,was conducted to compare mean changes in anthropometric parameters across the groups.INTRODUCTION Non-alcoholic fatty liver disease(NAFLD)has emerged as a global health burden,affecting approximately 1 in 4 in-dividuals worldwide.NAFLD ranges from simple steatosis(fat accumulation)to non-alcoholic steatohepatitis(NASH),and its global prevalence in the general population is estimated between 6.3%and 33%,with NASH affecting 3-5%[1,2].Obesity is a major risk factor of NAFLD,with studies showing that the likelihood of developing NAFLD increases 5-fold at a body mass index(BMI)of 30-32.5 kg/m²and up to 14-fold at BMI of 37.5-40 kg/m²compared to a BMI of 20-22.5 kg/m²[3,4].Effective NAFLD management requires both dietary and physical activity modifications.Healthy weight loss with sustained muscle mass plays a pivotal role,with a reduction of 3%-5%decreasing hepatic steatosis,5%-7%improving NASH conditions,and 10%or more needed to reverse hepatic fibrosis[5].Management also normalizes elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase),enhances insulin sensitivity,and thereby reduces cardiovascular risk by improving endothelial function and increasing cardiorespiratory fitness[6].However,diet or exercise alone is often not as effective as a combined approach.Integrating both balanced dietary changes and increased physical activity yields more sustainable improvements in NAFLD and overall metabolic health[1,7].Traditional intervention methods usually involve in-person consultations,which often lack real-time and continuous patient monitoring.The recommendation of drastic changes in diet and exercise can also be overwhelming for patients,leading to low adherence rates.Many patients struggle to maintain these changes in the long-term due to a lack of con-tinuous motivational support[8,9].In recent years,the health ecosystem has witnessed a significant shift toward digital health platforms,which complement pharmacological treatments in chronic disease management,and increase scala-bility.These platforms provide continuous monitoring and personalized support,helping to bridge the gap between health care setups and patients[10].Recent digital advances enable internet of things(IoT)devices to be integrated into such management plans to track health metrics,to address the limitations of traditional methods[11,12].The MyTatva digital health application offers the RESET plan,a novel comprehensive approach for NAFLD mana-gement by integrating personalized support from nutrition,physiotherapy,and cognitive behavioral therapy(CBT)coaches.We aimed to evaluate the effectiveness of the RESET plan by analyzing the reduction in anthropometric para-meters across three different digital intervention groups.
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.
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.
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.
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.
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.
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.
